AT 

i^OS  ANGELES 

UmAkY 


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THE  DISABLED  SOLDIER 


THE  MACMILLAN  COMPANY 

MEW  YORK    ■    BOSTON   •    CHICAGO  •    DALLAS 
ATLANTA   •    SAN    FRANCISCO 

MACMILLAN  &  CO.,  Limited 

LONDON  •  BOMBAY  •  CALCUTTA 
MBLBOURNB 

THE  MACMILLAN  CO.  OF  CANADA,  Ltd. 

TORONTO 


S3  ^ 


THE 
DISABLED  SOLDIER 

BY 

DOUGLAS  C.  McMURTRIE 

Director,  Red  Cross  Institute  for  Crippled  and  Disabled  Men 

President,  Federation  of  Associations  for  Cripples 

Editor,  American  Journal  of  Care  for  Cripples 

WITH  AN  INTRODUCTION  BY 

JEREMIAH  MILBANK 

Vice-Chairman,  Committee  of  Direction 
Red  Cross  Institute  for  Crippled  and  Disabled  Men 


iBtehJ  gorfe 


THE  MACMILLAN  COMPANY 
1919 


y^ll  Rights  Reser-ved 

119763 


Copyright,  1919 
By  THE  MACMILLAN  COMPANY 

Set  up  and  electrotyped.    Published  January,  1919 


Type  set  in  the  Printing  Department  of  the 
Red  Cross  Institute  for  Crippled  and  Disabled  Men 


us 

360 

dob, "3^ 


TO 

THE   AMERICAN    SOLDIERS    GONE    OUT    TO    FRANCE 

TO  RISK   PHYSICAL   DISABILITY  IN  THE   CAUSE 

OF  FREEDOM  AND   RIGHT 


CONTENTS 


CONTENTS 

CHAPTER  PAGE 

I .  A  Record  of  Injustice 1 

II,  Breaks  in  the  Wall 27 

III.  Orders  to  Advance 34 

IV.  First  Steps  to  Self-Support     ....  37 
V.  The  New  Schoolhouse 49 

VI.  At  Work  Again 79 

VII.  Help  or  Hindrance 96 

VIII.  Hors  de  Combat 113 

IX.  Out  of  the  Darkness 120 

X.  In  Wake  of  Battle's  Din         ....  134 

XI.  The  Step  in  Time 141 

XII.  Brink  of  the  Chasm 151 

XIII.  Allies  on  the  Continent    .       .       .        .       .160 

XIV.  Kingdom  and  Dominion         .       .       .       .185 
XV.  Across  the  Firing  Line           ....  209 

XVI.  For  the  U.  S.  Forces 223 


ILLUSTRATIONS 


ILLUSTRATIONS 

FACING  PACK 

Home  Again Frontispiece 

A  Procession  of  Cripples 22 

Goldsmith  and  the  Disabled  Sailor 23 

Where  There's  a  Will 30 

New  Tools  for  a  New  Trade 31 

Back  at  His  Old  Job 38 

An  Early  Start        . 39 

Improving  the  Mind 46 

American  Boys  "Carry  On" 47 

India's  Men  Go  to  School 54 

The  Future  Shipworker 55 

A  Cheerful  Pupil 62 

A  Motion  Picture  Operator  in  the  Making        .      .  63 

Business  as  Usual 80 

A  Busy  Workshop 81 

Learning  to  Walk  for  the  Second  Time  .      .      .      .  114 

A  "Working  Arm"  in  lieu  of  Nature's  Own            .  115 

Poultry  Raising  for  the  Blind 130 

Surmounting  a  Double  Handicap 131 

A  New  Way  to  Sharpen  a  Scythe 164 

Back  to  the  Soil 165 

Still  in  the  National  Service 194 

A  Wage-Earner  Once  More    ..;....  195 

The  Enemy  Conserves  Man- Power 210 

At  Work  Again— With  Four  Artificial  Limbs    .      .  211 


INTRODUCTION  IX 


INTRODUCTION 

There  has  been  evidenced  in  the  past  but  scant  public 
concern  in  the  welfare  of  the  disabled.  It  is  probable 
that  one  reason  for  this  has  been  the  failure  to  advocate, 
in  popular  form,  the  logic  of  the  arguments  in  favor  of 
rehabilitation  for  self-support — arguments  which  have 
only  to  be  made  clear  to  meet  with  cordial  and  hearty 
acceptance.  It  is  my  hope  that  the  present  volume 
will  go  far  to  promote  understanding  of  the  real  needs 
of  disabled  men,  and  enlist  public  interest  in  the  cause 
of  reconstruction. 

When  the  preparation  of  this  book  was  first  proposed, 
I  urged  that  the  project  be  carried  through.  That  I 
was  asked  to  write  the  introduction  is  presumably 
because  of  my  connection  with  the  Red  Cross  Institute 
for  Crippled  and  Disabled  Men,  which  was  established 
in  the  spring  of  1917  as  the  first  specialized  trade  school 
in  the  country  for  the  handicapped  adult. 

One  of  the  greatest  problems  to  be  met  in  the  successful 
establishment  of  any  new  institution  is  the  selection  of 
a  competent  director.  The  Institute  was  peculiarly  for- 
tunate in  securing  for  this  position  the  services  of  a  man 
so  well  qualified  by  experience  and  training  as  Douglas, 
McMurtrie.  For  the  past  eight  years  he  has  devoted 
a  large  part  of  his  time  and  effort  to  study  of  the  ob- 
stacles and  prejudices  that  confront  the  disabled  man, 
and  the  means  of  overcoming  them.  This  interest  has 
culminated  in  the  unselfish  devotion  of  himself,  his  time, 


INTRODUCTION 


his  energy,  and  his  enthusiasm  to  the  many  and  complex 
activities  of  the  institution  which  he  so  ably  directs. 

Under  his  leadership  the  Institute  has  already  proved 
its  value  and  assumed  an  important  position  in  the  field 
of  rehabilitation  and  re-education.  His  reward,  while 
not  pecuniary,  will  be  the  everlasting  gratitude  of  that 
great  army  of  unfortunate  individuals  who  have  formerly 
been  derelicts  on  the  rough  seas  of  misfortune,  but  to 
whom  now  has  been  given  a  greater  opportunity  to  face 
the  future  with  hope  and  courage. 


Jeremiah  Milbank 


PREFACE  XI 


PREFACE 

In  any  new  science  there  are  few  books  but  a  great  mul- 
tiplicity of  pamphlets,  periodical  articles,  and  reports 
which  baffle  the  reader  who  seeks  to  learn  the  state  of 
knowledge  on  the  subject.  The  rehabilitation  of  the 
disabled  soldier  is  no  exception  to  this  rule  and  it  has 
been  necessary  to  go  through  hundreds  of  documents  of 
an  ephemeral  nature  to  gain  a  clear  idea  of  what  prin- 
ciples have  been  developed  and  how  these  principles  are 
actually  being  put  into  practice. 

This  volume  aims  to  present  for  the  general  reader 
such  a  statement  of  theory  and  practice.  In  view  of  the 
extent  of  the  field  requiring  to  be  covered,  the  treatment 
is  necessarily  elementary.  But  in  view  of  the  wide  public 
interest  in  the  future  of  the  disabled  soldier,  and  the 
manner  in  which  the  new  reconstructive  work  of  redeem- 
ing injured  men  from  the  social  and  economic  scrap-heap 
has  laid  hold  on  the  popular  imagination,  it  is  felt  the 
book  may  meet  a  distinct  need. 

The  book  is  entitled  for  the  sake  of  brevity  "The 
Disabled  Soldier."  It  might  more  properly  be  named 
"The  Disabled  Soldier,  Sailor,  and  Marine,"  for  in  all 
countries  the  same  opportunities  are  extended  to  the 
members  of  all  branches  of  the  belligerent  service.  The 
word  "soldier"  in  the  text  should  always  be  read,  there- 
fore, with  this  qualification  in  mind. 


Xll  PREFACE 

The  literary  and  scientific  obligations  of  the  author 
are  extensive  and  almost  too  numerous  to  detail.  It  has 
not  seemed  feasible  in  a  work  of  this  kind  to  burden  the 
text  with  footnotes  and  references,  so  an  endeavor  will 
be  made  to  acknowledge  the  main  sources  of  personal 
assistance  and  data.  Most  vital  help  has  been  freely 
given  by  members  of  the  staff  of  the  Red  Cross  Institute 
for  Crippled  and  Disabled  Men,  among  them  Dr.  J.  C. 
Faries,  Mr.  Howard  R.  Heydon,  Mr.  Harry  Birnbaum, 
Mrs.  Donald  Whiteside,  Miss  Florence  Sullivan,  Miss 
Gertrude  Stein,  Miss  Ruth  Underhill,  Mr.  Alexander 
Gourvich,  Mr.  Gustav  Schulz,  and  Miss  Letty  L.  Davis. 
Mr.  Jeremiah  Milbank,  also  of  the  Institute,  and  a  dis- 
tinguished benefactor  in  the  cause  of  the  cripple,  has 
been  so  kind  as  to  write  the  introduction.  These  staff 
colleagues  have  not  only  helped  generously  in  many  ways 
during  the  preparation  of  the  manuscript,  but  have  also 
read  the  proofs  to  check  them  for  accuracy  and  to  offer 
suggestions.  Their  part  in  the  production  is  most  cor- 
dially appreciated. 

The  individual  chapters  have  been  read  by  various 
authorities,  to  whom  I  am  indebted  for  criticisms  and 
suggestions  and  checking  as  to  accuracy  of  statement — 
the  chapter  on  "First  Steps  to  Self-Support"  by  Lt.-Col. 
Casey  A.  Wood,  M.  C,  U.  S.  A.  and  by  Dr.  Herbert  J. 
Hall,  of  Marblehead,  Mass.;  "The  New  Schoolhouse" 
by  Mr.  W.  E.  Segsworth,  Director  of  Vocational  Training 
of  the  Invalided  Soldiers'  Commission  of  Canada,  and 
by  Dr.  James  C.  Miller,  now  on  the  staff  of  the  Federal 
Board  for  Vocational  Education;    the  chapter  entitled 


PREFACE  Xlll 

"Hors  de  Combat"  by  Lt.-Col.  David  Silver,  M.  C, 
U.S.A.;  "Out  of  the  Darkness"  by  Lt.-Col.  James 
Bordley,  M.  C,  U.  S.  A.,  and  director  of  the  Red  Cross 
Institute  for  the  Blind,  and  by  Mr.  C.  F.  F.  Campbell, 
of  the  same  Institute;  "In  Wake  of  Battle's  Din"  by 
Lt.-Col.  Charles  W.  Richardson,  M.  C,  U.  S.  A.;  "The 
Step  in  Time"  by  Dr.  Henry  Barton  Jacobs  and  by  Mr. 
William  H.  Baldwin,  treasurer  of  the  National  Associa- 
tion for  the  Study  and  Prevention  of  Tuberculosis; 
"Brink  of  the  Chasm"  by  Major  George  H.  Kirby,  M.  C, 
U.S.A.;  "For  the  U.  S.  Forces"  by  Mr.  Curtis  E. 
Lakeman,  of  the  Department  of  Civilian  Relief  of  the 
American  Red  Cross.  I  have  further  received  much  of 
value  from  the  comments  and  correspondence  of  Miss 
Grace  Harper  and  Captain  H.  W.  Miller,  both  with  the 
American  Red  Cross  in  France. 

For  the  use  of  photographs  illustrating  the  recon- 
struction of  disabled  American  soldiers,  I  am  indebted 
to  the  Instruction  Laboratory  of  the  Surgeon  General, 
U.  S.  Army. 

From  the  literature  much  data  has  been  gleaned. 
Some  of  the  principal  authors  to  whom  acknowledg- 
ment should  be  made  are  Eugene  Brieux,  Dr.  Maurice 
Bourrillon,  L6on  de  Paeuw,  Gustave  Hirschfeld,  Prof. 
Ettore  Levi,  Sir  John  Collie,  Major  Robert  Mitchell, 
John  Galsworthy,  Sir  Arthur  Pearson,  A.  G.  Baker,  Dr. 
Konrad  Biesalski,  Dr.  J.  R.  Byers,  Dr.  J.  Dundas  Grant, 
Lt.-Col.  E.  N.  Thornton. 

The  book  has  been  set  up  in  the  printing  department 
of  the  Red  Cross  Institute.     The  care  taken  by  Miss 


XIV  PREFACE 

Inez  Rodimon,  Mr.  William  J.  Howe,  and  Mr.  Aage 
Petersen,  of  the  stafif  of  that  department,  in  putting  the 
manuscript  into  type  has  materially  lessened  the  work 
of  the  author. 

It  may  be  noted  in  passing  that  the  royalties  on  this 
volume  have  been  assigned  to  the  Red  Cross  Institute 
for  Crippled  and  Disabled  Men,  as  the  director  of  which 
the  writer  has  been  privileged  to  serve  in  a  volunteer 
capacity. 

Douglas  C.  McMurtrie 

311  Fourth  Avenue 
New  York 


RECORD      OF      INJUSTICE 


CHAPTER  I 

A  RECORD  OF  INJUSTICE 

Beyond  reaches  of  history,  the  disabled  man  has  been 
a  castaway  of  society.  In  the  far  east,  the  tribes  of 
ancient  India  turned  out  their  deformed  members  to 
wander  in  the  wilderness  and  perish  of  exposure;  here 
in  America,  among  the  Aztecs,  deformed  persons  were 
sacrificed  in  time  of  famine  and  need,  or  on  the  death  of 
kings  and  great  men. 

The  disabled  wolf  is  torn  to  pieces  by  the  pack ;  primi- 
tive society  abandoned,  expelled,  put  to  death  its  dis- 
abled and  deformed  members.  Superstition  was  no 
doubt  partly  responsible  for  this  savage  practice,  but  it 
is  conceivable  that  it  was  in  great  measure  due  to  purely 
material  considerations.  In  an  age  when  life  was  a  bare- 
handed struggle  against  starvation  and  death  from  man 
and  beast,  the  tribe  must  have  felt  that  its  crippled 
members  were  useless  if  not  dangerous  burdens.  They 
had  to  perish  in  the  ruthless  struggle  for  existence. 

In  the  course  of  time,  primitive  man  came  to  anticipate 
the  operation  of  the  natural  law  of  selection  by  putting 
the  deformed  to  death  as  soon  as  they  were  born. 

Yet,  with  the  dawn  of  civilization  and  the  development 
of  pastoral  and  agricultural  life,  the  condition  of  the 
cripple  did  not  improve  to  the  extent  that  might  have 
been  expected.  Oriental  peoples  turned  forth  their 
cripples  to  wander  in  the  wilderness,  the  inhabitants  of 
India  cast  them  into  the  Ganges,  the  Spartans  hurled 
them  from  a  precipice,  the  Hebrews  banished  them  so 


2 THE      DISABLED      SOLDIER 

that  their  cripples  had  perforce  to  beg  by  the  roadsides. 
The  exposure  of  deformed  and  "superfluous"  infants  re- 
mained a  widespread  and  long-lived  practice.  Among 
some  peoples  the  motives  underlying  these  customs  were 
intentionally  eugenic,  in  a  primitive  way;  in  general, 
however,  they  seem  to  have  been  partly  economic  and 
partly  superstitious.  With  regard  to  the  latter,  the 
superstitious  motives,  it  is  a  curious  fact  that  whereas 
primitive  peoples  have  frequently  found  something 
sacred — a  touch  of  the  divine — in  persons  afflicted  with 
disorders  of  the  mind,  bodily  deformity  seems  to  have 
been  quite  generally  regarded  as  a  blight  sent  by  the 
gods,  a  punishment  for  sin,  evidence  of  traffic  with 
devils. 

This  belief  that  the  physically  deformed  are  spiritually 
unfit  has  left  its  trace  in  the  Hebrew  scripture.  Moses 
decreed  that  a  man  blind,  lame,  brokenfooted,  broken- 
handed,  "crooktbackt,"  or  dwarfed  should  not  make 
offering  to  the  Lord  lest  the  sanctuary  be  profaned.  The 
Greeks,  worshipping  perfection  in  bodily  form,  looked 
upon  the  cripple  as  the  incarnation  of  everything  un- 
lovely, not  only  physically  but  mentally  and  morally 
as  well.  Thersites  is  described  by  Homer  as  possessed 
of  every  ugly  attribute,  deformed  equally  in  body  and 
mind. 

The  history  of  the  social  attitude  toward  the  cripple 
is  bound  up  with  the  history  of  the  development  of 
charity.  The  literature  of  antiquity  is  rife  with  refer- 
ences to  beggars  and  beggary;  to  give  alms  was  held 
to  be  a  kind  of  obligation,  more  or  less  automatically 
performed.  With  its  performance,  all  social  obligation 
was  fulfilled.  As  a  result  of  this  attitude,  kindly  refer- 
ences to  the  cripple  are  rare  in  ancient  literature.    Job 


RECORD      OF      INJUSTICE 


recites  as  one  of  his  benevolences  that  he  was  eyes  to 
the  blind  and  feet  to  the  lame.  In  one  of  the  sacred  books 
of  the  East  it  is  stated  that  the  inheritance  share  of  a 
son  crippled  in  both  feet  or  maimed  in  both  hands  should 
be  twice  the  share  of  one  who  is  sound. 

The  most  highly  developed  civilization  of  antiquity, 
that  of  Athens,  provided  a  system  of  relief  for  those  of 
its  citizens  who  were  unable  to  earn  a  livelihood  on 
account  of  bodily  defects  and  infirmities.  The  qualifi- 
cation was  a  property  test :  it  had  to  be  proven  that  the 
applicant  had  no  property  in  excess  of  three  minae 
(about  $100  in  present  purchase  values).  The  senate 
examined  the  case,  the  ecclesia  awarded  the  bounty, 
which  was  one  or  two  ohols  a  day — enough  for  a  bare 
sustenance. 

The  advent  of  Christianity  struck  a  new  note  in  the 
attitude  toward  the  crippled  and  the  deformed.  Even 
in  Isaiah's  prophecy  of  the  coming  of  the  Messianic 
kingdom,  he  foretells  that  "then  shall  the  lame  man  leap 
as  a  hart."  Christ,  referring  to  his  ministry,  says:  "The 
blind  receive  their  sight,  and  the  lame  walk."  It  is  also 
related  that  the  blind  and  the  lame  "came  to  Him  in  the 
temple  and  He  healed  them." 

Many  cures  of  cripples  are  attributed  to  the  Apostles. 
"A  certain  man  lame  from  his  mother's  womb"  was 
healed  by  Peter.  It  is  related  that  "immediately  his 
feet  and  ankle  bones  received  strength."  During  the 
ministry  of  Philip  "many  taken  with  palsies  and  that 
were  lame,  were  healed."  During  the  mission  of  the 
Apostle  Paul  to  Lycaonia,  he  healed  a  cripple  described 
as  follows:  "And  there  sat  a  certain  man  at  Lystra, 
impotent  in  his  feet,  being  a  cripple  from  his  mother's 
womb,  who  had  never  walked." 


4  THE      DISABLED      SOLDIER 

For  all  that  it  represented  a  distinct  step  forward,  the 
new  influence  was  not  profound.  The  Christian  Councils 
did  their  best  to  combat  the  ancient  custom  of  exposing 
or  abandoning  deformed  infants;  but,  despite  their 
efforts  and  the  laws  of  the  Christian  Emperors — Con- 
stantine,  Valentinian,  Justinian — the  custom  survived. 
Gradually,  by  way  of  humanizing  this  practice,  the  insti- 
tution known  as  the  "turning  slide"  became  a  feature  of 
church  doors;  the  deformed  foundlings  thus  received 
were  taken  care  of  in  creches,  hospitals,  asylums,  refuges 
for  the  blind,  the  deaf,  the  crippled,  the  defective.  In 
590  A.  D.,  St.  Gregory  reformed  the  administration  of 
the  church  and  of  charity  in  the  city  of  Rome  in  an 
elaborate  manner;  one  of  his  provisions  was  that  the 
sick  and  the  infirm  were  to  be  superintended  by  persons 
appointed  to  inspect  every  street.  But  the  recognized 
mode  of  providing  for  the  disabled  remained  in  general 
what  it  had  been  in  antiquity — almsgiving  in  response 
to  begging.  In  Constantinople  pauperism  became  so 
extreme  during  the  fourth  century  that  the  Emperor 
Constantine  decreed  that  all  able-bodied  beggars  were  to 
be  condemned  to  slavery;  the  inference  that  beggary 
was  to  be  reserved  for  the  disabled  is  quite  apparent. 
In  Queen  Elizabeth's  day,  more  than  a  thousand  years 
later,  we  meet  the  phrase  "sturdy  beggars"  with  a  similar 
implication.  Between  these  dates  we  have  Charlemagne's 
order  that  no  one  was  to  presume  to  give  relief  to  able- 
bodied  beggars  unless  they  were  set  to  work. 

In  all  justice  to  the  Middle  Ages  it  must  be  pointed 
out,  however,  that  casual  almsgiving  was  not  the  sole 
relief  provided.  The  church  was  actively  engaged  in 
relief  work,  at  first  on  a  parochial  basis,  then  on  an  insti- 
tutional.   Side  by  side  with  the  centers  established  in  the 


RECORD      OF      INJUSTICE 


monasteries,  there  grew  up  a  system  of  endowed  chari- 
ties, also  under  church  rule,  for  the  care  of  the  "poor" 
and  the  "sick"  and  others  in  need  of  aid;  it  is  fair  to 
assume  that  the  crippled  and  the  deformed  were  in- 
cluded in  these  categories,  although  specific  mention 
of  them  rarely  occurs.  Thus,  along  with  other  hospitals 
established  at  Canterbury  in  England  during  the  twelfth 
century,  there  was  one  for  "poor,  infirm,  lame  and  blind 
old  men  and  women."  That  all  these  institutions  pro- 
vided relief  of  the  most  primitive  kind  only  need  not 
be  emphasized. 

Before  pursuing  further  the  gradual  evolution  of  the 
relief  afforded  the  crippled  and  the  deformed,  it  will 
pay  to  consider  the  use  which  ancient  and  medieval 
society  made  of  these  unfortunates. 

As  it  developed  in  luxury  and  culture,  antiquity  found 
a  characteristic  employment  for  some  types  of  the  de- 
formed, especially  for  the  dwarfed  and  the  grotesquely 
shaped.  There  are  extant  ancient  Greek  representations 
of  comic  figures  of  this  sort — forerunners,  possibly,  of 
the  medieval  court  fool.  Attic  comedy  made  constant 
use  of  actors  padded  to  simulate  various  types  of  de- 
formity. The  tradition  that  has  come  down  to  us  with 
regard  to  ^sop  presents  the  author  of  the  fables  as 
born  to  slavery  and  deformity;  and  although  modern 
historians  seem  to  be  doubtful  as  to  whether  .^sop  ever 
existed  or  not,  it  is  significant  that  tradition  has  created 
such  a  personality  and  that  the  oldest  writer  to  mention 
his  person  speaks  of  his  appearance  and  his  voice  as  con- 
tributing as  much  as  his  stories  to  the  amusement  of 
his  company. 

But  this  comic  exploitation  of  deformity,  brutal  as 
it  must  seem  to  us,  is  the  brighter  side  of  the  picture. 


6  THE      DISABLED      SOLDIER 

Seneca  has  left  an  appalling  record  of  how  some  Roman 
masters  exploited  deformed  slave  children  as  beggars. 
If,  as  they  grew  older,  their  deformities  were  not  con- 
spicuous enough  to  excite  compassion,  the  poor  creatures 
were  intentionally  crippled  to  an  even  greater  extent: 
their  arms  were  cut  off,  their  shoulders  twisted  so  that 
they  became  humpbacked.  If  the  day's  earnings  were 
not  sufficient,  the  master  rebuked  the  wretches,  saying: 
"You  have  brought  in  too  little,  bring  hither  the  whip; 
you  can  weep  and  lament  now.  Had  you  appealed  thus 
to  the  passer-by,  you  could  have  had  more  alms  and  you 
could  have  given  me  more." 

The  Middle  Ages,  like  antiquity,  exploited  the  appeal 
that  physical  deformity  makes  to  a  primitive  sense  of 
the  comic.  The  court  fool  or  jester  was  to  be  'found 
almost  universally  in  the  retinues  of  princes  and  often 
in  the  households  of  noblemen.  The  type  literature  has 
seized  upon  and  immortalized  was  characterized  less  by 
physical  deformity  than  by  a  certain  superficial  quick- 
ness of  wit  and  power  of  repartee;  by  far  the  greater 
number,  however,  consisted  merely  of  creatures  who' by 
reason  of  deformity  of  mind  or  body  were  calculated  to 
excite  heartless  laughter  or  ridicule.  The  institution 
was  firmly  entrenched  for  many  years,  despite  many 
tendencies  operating  to  improve  the  situation.  Even  a 
number  of  decrees  passed  by  the  Reichstag  in  the  six- 
teenth century  failed  to  obviate  the  practice.  Not 
until  the  Enlightenment  was  the  final  stage  reached  and 
the  custom  abolished. 

Even  after  this  time,  the  court  fool  was  still  in  vogue 
in  the  Russian  court,  Peter  the  Great  having  so  many 
jesters  of  this  type  that  it  was  necessary  to  divide  them 
into   classes.     When    the   Spaniards    under    Fernando 


RECORD      OF      INJUSTICE 


Cortez  accomplished  the  conquest  of  Mexico,  court  fools 
and  deformed  human  creatures  of  all  kinds  were  found 
at  the  court  of  Montezuma. 

Seneca's  picture  of  the  inconceivable  brutality  of  some 
Roman  masters  has  its  medieval  pendant  in  the  picture 
drawn  by  Sebastian  Brant  in  his  "Narrenschiff."  This 
German  satire  was  done  into  English  by  Alexander 
Barclay  in  1509,  under  the  title  of  "The  Ship  of  Fools." 
The  following  is  a  slightly  modernized  quotation  from 
Barclay's  version : 

Some  other  beggers  falsly  for  the  nones 

Disfigure  their  children,  God  wot,  unhappily, 

Mangling  their  faces,  and  breking  their  bones 

To  stir  the  people  to  pity  that  passe  by. 

There  stande  they  begging  with  tedious  shout  and  cry, 

Their  own  bodies  turning  to  a  strange  fashion 

To  move  such  as  passe  to  pity  and  compassion. 

Heartless  ridicule,  inhuman  exploitation,  and,  with  it 
all,  "pity  and  compassion."  Add  to  this  the  superstitions 
— the  belief  in  "changelings,"  in  the  "evil  eye,"  in  satanic 
paternity,  which  the  medieval  mind  generally  advanced 
by  way  of  "explaining"  deformity — and  the  strange  pic- 
ture is  complete. 

If  space  permitted,  it  would  be  instructive  at  this 
point  to  consider  in  detail  the  role  the  cripple  has  played 
in  literature.  Allusion  has  already  been  made  to  Ther- 
sites,  who  serves  Homer  not  only  as  a  foil  to  the  heroic 
splendor  of  Achilles  and  Ulysses,  but  also  as  a  maker  of 
trouble  and  sower  of  discord.  In  the  Siegfried  saga,  the 
dwarf  Mime  plays  a  similar  part.  And  in  Shakespeare's 
Richard  III  we  have  a  classic  presentation  of  the  cripple 


8  THE      DISABLED      SOLDIER 

as  "villain."  In  the  opening  monologue  of  the  play, 
Shakespeare  gives  us  a  glimpse  of  the  psychology  of  the 
cripple  as  he  conceived  it : 

But  I,  that  am  not  shap'd  for  sportive  tricks, 

Nor  made  to  court  an  amorous  looking-glass; 

I  that  am  rudely  stamp'd,  and  want  love's  majesty 

To  strut  before  an  ambling  wanton  nymph; 

I  that  am  curtail'd  of  this  fair  proportion. 

Cheated  of  feature  by  dissembling  nature, 

Deform'd,  unfinish'd,  sent  before  my  time 

Into  this  breathing  world,  scarce  half  made  up, 

And  that  so  lamely  and  unfashionable 

That  dogs  bark  at  me  as  I  halt  by  them; 

Why,  I,  in  this  weak  piping  time  of  peace, 

Have  no  delight  to  pass  away  the  time 

Unless  to  see  my  shadow  in  the  sun 

And  descant  on  mine  own  deformity, 

And  therefore,  since  I  cannot  prove  a  lover 

To  entertain  these  fair  well-spoken  days, 

I  am  determined  to  prove  a  villain 

And  hate  the  idle  pleasures  of  these  days. 

Plots  have  I  laid,  inductions  dangerous, 

By  drunken  prophecies,  libels,  and  dreams, 

To  set  my  brother  Clarence  and  the  King 

In  deadly  hate  the  one  against  the  other; 

And  if  King  Edward  be  as  true  and  just 

As  I  am  subtle,  false,  and  dangerous. 

This  day,  etc. 

Shakespeare's  learned  and  philosophic  contemporary, 
Lord  Bacon,  in  his  "Essay  on  Deformity"  strikes  a  similar 
note,  holding  that  "deformed  persons  are  commonly 
even  with  Nature;  for  as  Nature  hath  done  ill  by  them, 
so  do  they  by  Nature,  being  for  the  most  part  . 
void  of  natural  affection." 


RECORD      OF      INJUSTICE 


Writing  almost  two  centuries  after  Shakespeare,  Schiller, 
in  his  earliest  play,  "The  Robbers,"  presents  an  inter- 
esting parallel  to  Shakespeare's  Richard  III  in  the  figure 
of  Franz  Moor,  who  says: 

I  have  potent  reasons  to  be  out  with  Nature,  and  on  my 
honor  I   shall  press  them  all  .  .  Why  did  she  burden  me 

with  this  load  of  ugliness?      Why   me,  of  all  people?    . 
Verily,  I  believe  she  threw  into  a  single  heap  all  the  despicable  ele- 
ments of  mankind,  and  baked  me  therefrom.     Death  and  devils! 
Who  gave  her  the  authority  to  dower  others  with  this  and  that,  and 
to  withhold  these  things  from  me? 

Later  he  cries  out,  pathetically  enough,  as  if  with  a  laugh 
of  grim  irony: 

But  is  it  just  to  damn  a  man  because  of  his  deformity?  In  the 
most  wretched  of  cripples  there  may  shine  a  great  and  lovable  soul, 
like  a  ruby  buried  in  mud. 

In  conformity  with  medieval  tradition,  Goethe  in 
"Faust"  provides  Mephisto  with  a  limp.  Stevenson's 
genial  cutthroats  in  "Treasure  Island"  are  variously  muti- 
lated; and  even  one  of  our  own  present-day  novelists 
has  a  penchant  for  legless  and  one-eyed  villains! 

But,  from  the  end  of  the  eighteenth  century  down, 
literature  has  grown  increasingly  rich  in  imaginative 
works  that  are  not  obsessed  with  this  idea  of  a  relation 
between  physical  and  moral  deformity.  From  Quasi- 
modo to  Little  Eyolf,  from  Tiny  Tim  to  Richard  Cal- 
mady,  the  cripple  has  been  presented  with  a  freshness 
of  vision  and  a  realistic  insight  that  mark  the  dawn  of 
a  new  era  for  this  social  castaway.  Perhaps  the  change 
cannot  be  more  strikingly  indicated  than  in  the  follow- 
ing translation  from  "an  old  manuscript"  first  published 
in  1806;  in  its  lonesomeness,  its  resignation,  its  poignant 
imagery,  the  little  poem  is  a  most  revealing  bit  of  the 


10  THE      DISABLED      SOLDIER 

true   psychology  of  the  cripple   under  adverse  social 
conditions : 

Dear  hand  of  God! 

Lighten  my  heart, 

Help  me  to  find 

Fun  in  my  smart. 

Methinks  the  dear  Lord  , 

At  toss-ball  doth  play, 

The  harder  he  strikes  me. 

The  higher  my  way. 

Or  I  am  a  sapling 
A  garden  within, 
God  is  the  gard'ner 
And  bends  me  to  Him, 
He  cuts  me  and  prunes  me 
And  bends  every  limb, 
So  I  may  grow  upward 
And  nearer  to  Him. 

Oh,  let  me  proclaim  it, 
God  cuts  to  the  bone. 
He  chips  me  and  hews  me, 
But  I  make  no  moan, 
You  marvel  and  wonder? 
I  think  it  His  wish 
To  sculpture  an  angel 
Out  of  my  flesh. 

The  dawn  of  a  new  era!  It  is  probably  fair  to  say 
that  the  old  era  was  summed  up  and  the  new  era  pre- 
pared for  by  a  Spaniard  named  Vives  who  published  a 
book  early  in  the  sixteenth  century  on  the  subject  of 
the  management  of  the  poor — a  book  which  was  trans- 
lated into  several  languages  and  widely  read.  Vives 
divided  the  poor  into  three  classes:  those  in  hospitals 
and  poor-houses,  public  homeless  beggars,  the  poor  at 
home.      He   proposed  a  census   of    the   poor   in   each 


RECORD      OF      INJUSTICE  11 

town  and  the  collecting  of  data  as  to  the  causes  of 
distress.  Then  he  planned  the  establishment  of  a  central 
organization  of  relief  under  the  magistrates.  Beggary 
was  to  be  strictly  prohibited;  work  was  to  be  provided 
for  all.  The  non-settled  poor  who  were  able-bodied 
were  to  be  returned  to  their  native  homes;  the  able- 
bodied  settled  poor  who  knew  no  craft  were  to  be  put 
on  some  public  work — the  undeserving  being  set  to  hand 
labor;  for  the  others,  work  was  to  be  found,  or  they  were 
to  be  assisted  to  become  self-supporting.  Hospitals 
were  to  be  classified  to  meet  the  needs  of  the  sick,  the 
blind,  the  insane.  Funds  were  to  be  obtained  chiefly 
from  private  sources  and  from  the  church. 

The  Sorbonne  approved  this  scheme;  the  city  of 
Ypres  put  it  into  effect  in  1524;  similar  plans  were 
adopted  in  Paris  and  elsewhere.  Queen  Elizabeth's 
Poor  Relief  Act  of  1601  was  largely  based  on  it.  It 
was  an  ambitious  scheme  for  the  administrative  tech- 
nique of  the  age;  but,  whatever  its  success,  it  had  in 
it  the  seed  of  a  rational  approach  to  the  problem  of 
the  poor  in  general  and  of  the  disabled  and  the  de- 
formed in  particular. 

Influenced,  it  may  well  be,  by  this  Spanish  book. 
President  de  Pomponne  de  Believre  founded  in  France 
in  1657  an  asylum  in  which  the  infirm  could  find  suitable 
work.  Despite  several  sporadic  imitations  of  this  project, 
which  later  became  the  Salpetri^re,  the  early  measures 
did  not  in  a  strict  sense  mark  the  beginnings  of  care  for 
cripples,  but  they  operated  to  the  ultimate  advantage  of 
those  who,  by  reason  of  their  infirmity,  were  cast  upon 
the  pity  of  their  fellow  men.  The  actuating  motive  of 
provision  in  many  cases,  however,  was  utilitarian  in 
character.    One  object — an  object  avowed  by  Vives,  for 


12  THE      DISABLED      SOLDIER 

instance — was  that  all  cripples  might  be  so  confined  that 
they  should  not  annoy  the  community  by  their  deformed 
appearance,  and  the  streets  and  highways  be  rid  of 
beggars. 

Some  of  the  many  monasteries  which  had  not  been 
utilized  since  the  time  of  the  Reformation  were  thrown 
open  and  converted  into  orphan  asylums,  mad-houses, 
or  penitentiaries.  In  the  establishment  of  the  various 
institutions  the  cripple  was  frequently  considered.  For 
instance,  those  handicapped  by  deformity  were  provided 
for  at  a  hospital  for  wretched  and  pauper  invalids  estab- 
lished at  Pforgheim  in  1722  by  Count  Luitgard  of  Baden. 
This  was  later  transformed  by  Count  Charles  Frederic 
of  Baden  into  an  orphan  asylum,  making  especial  pro- 
vision, however,  for  young  and  old  cripples.  According 
to  the  official  ordinance  creating  this  institution,  the 
third  class  of  inmates  was  to  be  composed  of  "those  who 
have  such  physical  defects  that  they  are  an  especial 
abomination  and  disgust  to  other  men  whenever  they 
come  into  their  sight."  The  cripple  department  was, 
however,  abolished  in  1808,  probably  because  the  quar- 
ters were  needed  for  the  insane. 

Such  provision  for  cripples,  however,  gave  them  asylum 
only  and  did  nothing  to  better  their  condition.  The  rise 
of  the  science  of  orthopedics  was  responsible  for  the 
ensuing  improvement.  The  theories  of  the  various  ortho- 
pedists were  best  put  into  practice  in  an  institution,  and 
a  large  number  of  these  were  founded  in  the  first  decades 
of  the  nineteenth  century;  as,  for  example,  those  lo- 
cated at  Paris,  London,  Leipzig,  Liibeck,  Berlin,  Vienna, 
and  Stockholm. 

The  first  institution  in  the  world  with  an  all-around 
program   for  ameliorating  the  lot   of  the   cripple  was 


RECORD      OF      INJUSTICE  13 

established  in  Munich  in  1832,  but  this  was  devoted 
particularly  to  the  care  of  crippled  children.  A  long 
period  followed  before  the  creation  of  the  second  estab- 
lishment of  the  same  sort  which  came  into  being  in 
Copenhagen  in  1872.  From  this  time  on,  the  number 
of  schools  for  crippled  children  rapidly  increased. 

But  for  the  care  of  the  disabled  adult  there  was 
no  provision  at  all. 

In  the  foregoing  sketch  of  the  history  of  the  social 
attitude  toward  the  crippled  and  disabled  individual,  no 
mention  has  been  made  of  the  care  of  the  war  cripple, 
the  disabled  soldier.  The  subject  deserves  a  section  to 
itself,  despite  the  fact  that  in  its  broad  outlines  it  parallels 
the  tragic  history  of  the  care  of  the  cripple  in  general. 

Historians  have  done  very  little  to  lift  the  veil  that 
covers  the  fate  of  the  disabled  soldier  of  ancient  times. 
In  view  of  the  limitations  of  primitive  medical  and  sur- 
gical science,  and  of  the  custom  of  dispatching  the  enemy 
wounded  after  the  field  had  been  won,  there  is  every 
reason  to  believe  that  it  is  a  bloody  veil.  It  is  recorded, 
however,  that  ancient  Athens  fed  its  disabled  soldiers  at 
the  state's  expense,  and  that  Rome  under  Augustus  paid 
for  the  keep  of  its  disabled  legionaries  out  of  public  funds. 
Veteran  legionaries  were  often  provided  for  by  grants  of 
settlements  on  the  frontiers  of  the  empire. 

During  the  Middle  Ages,  when  warfare  was  on  a 
feudal  basis,  only  those  sufficiently  well-off  to  equip 
themselves  took  part  in  military  enterprises;  they  were 
relatively  few  in  number  and  usually  able  to  care  for 
themselves  in  the  event  of  permanent  disability.  At  the 
time  of  the  Crusades,  Philip  Augustus  of  France  enter- 
tained the  project  of  a  hospice  for  disabled  soldiers.  The 
Pope  congratulated  him  on  his  plan,  and  endowed  the 


14  THE      DISABLED      SOLDIER 

institution  in  advance  with  certain  privileges.  St.  Louis 
of  France,  returned  from  the  Crusades  with  his  shattered 
hosts,  did  actually  establish  an  asylum  for  some  300 
soldiers  blinded  by  "the  Asiatic  sun."  In  most  cases, 
however,  the  disabled  soldier  was  thrown  upon  private 
charity  for  support.  This  duty  devolved  upon  the  lord 
who  had  brought  his  vassals  to  the  king,  and  upon  the 
monasteries. 

With  the  crumbling  of  the  feudal  system,  and  the 
development  of  standing  armies  during  the  fifteenth 
century,  the  professional  soldier  came  into  being.  And 
from  that  time  on,  the  disabled  soldier  was  a  recognized 
type. 

How  was  he  provided  for?  For  a  time  shift  was  made 
with  the  dispensation  of  private  charity,  monastic  and 
otherwise.  Supplied  with  the  proper  credentials,  the 
disabled  soldier  would  present  himself  at  a  monastery, 
and,  after  promising  to  obey  the  rules  and  to  wear  the 
garb  of  the  institution,  he  would  be  admitted  as  a  lay- 
monk.  Few,  however,  found  the  life  endurable.  A 
French  writer  of  the  sixteenth  century  described  the 
conditions  in  these  terms:  "Once  the  poor  soldier  is 
received  [into  the  abbey],  he  may  not  abide  a  fortnight 
before  most  of  the  monks,  deriding  his  hardships,  his 
perils,  his  wounds  ...  do  put  so  many  obstacles  in 
his  path  that  he  is  fain  to  compound  for  a  pension  of 
fifty  or  sixty  litres  and  betake  himself  elsewhere."  De- 
parting, the  soldier  would  sell  his  annuity  for  a  trifle, 
which  he  would  spend  on  drink,  speedily  lapsing  into 
the  ranks  of  beggars  and  cutthroats  with  which  the 
countryside  was  infested. 

In  England,  with  the  expropriation  of  the  monasteries, 
the  disabled  soldiers  were  thrown  wholly  upon  the  charity 


RECORD      OF      INJUSTICE 15 

of  their  leaders.  In  Queen  Elizabeth's  time,  the  captains 
of  forces  in  Flanders  complained  that  they  were  expected 
to  make  provision  for  the  sick  and  wounded  "whose 
charge  lay  heavily  on  them."  The  Queen  was  "troubled 
whenever  she  took  the  air  by  these  miserable  creatures." 
Toward  the  end  of  her  reign,  steps  were  taken  to  provide 
for  "maimed,  hurt,  or  grievously  sick  soldiers,"  but  little 
good  was  accomplished. 

From  this  point  on,  in  the  interests  of  clearness,  it 
will  be  advisable  to  trace  the  history  of  the  care  of  the 
disabled  soldier  in  France,  first,  and  then  to  return  to 
England,  and  then  to  review  the  provident  measures  as 
they  were  developed  in  America.  Italy  and  Germany, 
politically  disorganized  in  great  measure  down  to  the 
latter  half  of  the  nineteenth  century,  have  little  to  offer 
that  is  interesting  until  we  come  to  very  recent  times. 

In  France,  then,  toward  the  end  of  the  sixteenth 
century,  after  the  close  of  the  civil  wars,  the  problem 
finally  became  acute.  A  multitude  of  crippled  and 
broken  soldiers  appealed  to  the  victor,  Henry  IV,  for 
the  "means  to  live  at  ease  the  rest  of  their  lives."  They 
were  all  ruined  men,  they  said,  because  either  they  had 
several  times  endured  capture  by  the  enemy  and  had 
been  obliged  to  ransom  themselves,  or  else  they  had 
been  wounded  and  had  expended  their  worldly  goods 
for  medical  treatment.  "They  had  been  reduced  to 
beggary,  a  shameful  thing  for  the  military  order."  The 
king  was  touched ;  and  after  considering  various  expedi- 
ents, hit  upon  the  idea  of  providing  a  hospice  for  the 
war  disabled. 

To  this  end,  he  took  over  an  asylum  that  had  been 
established  for  orphans  who  were  to  become  apothe- 
caries, changed  its  name  to  the  Maisun  Royale  de  la 


16  THE      DISABLED      SOLDIER 

Charite  chrSiienne,  and  decreed  that  the  institution  was 
to  be  supported  by  all  the  excess  revenues  that  could 
be  found  in  the  budgets  of  the  charitable  institutions 
— chiefly  monastic — in  France.  To  gain  admittance,  the 
wounded  soldier  had  to  present  a  certificate  from  his 
captain  or  colonel  stating  how  long  he  had  served,  the 
"combats,  perils,  and  hazards  he  had  been  exposed  to," 
his  "valor,"  and  in  what  "military  actions"  he  had  been 
wounded. 

Unfortunately,  however,  the  commissioners  of  the  in- 
stitution were  unable  to  collect  a  single  livre  from  the 
administrators  of  the  charitable  institutions  in  France. 
Their  budgets,  so  the  administrators  declared,  contained 
no  surpluses!  In  a  few  years  the  institution  was  prac- 
tically defunct.  In  1611,  Louis  XIII,  successor  to 
Henry  IV,  closed  the  doors  of  the  Maison  and  returned 
it  to  the  embryonic  apothecaries.  The  disabled  inmates 
who  had  survived  were  pensioned,  and  very  liberally. 

But  only  for  a  little  while.  The  need  for  state  funds 
soon  operated  to  reduce  the  annuities.  The  pensioners 
complained.  "We  receive,"  said  they,  "a  mere  alms, 
both  odious  and  repugnant  to  the  deserts  of  our  quality, 
for  the  most  part  gentlemen,  captains,  and  men  full  of 
honors  and  courage."  The  pension  system  was  revised. 
Again  the  monasteries  were  drawn  upon  for  funds.  Each 
monastery  was  to  support  its  quota  of  disabled  soldiers. 
But  the  pension  was  inadequate,  the  red  tape  and  trouble 
involved  in  collecting  it  was  interminable.  Before  long 
most  of  the  soldiers  had  sold  their  pension  rights,  and 
again  the  countryside  was  terrorized  by  wandering 
beggars,  thieves,  and  cutthroats. 

Convinced  of  the  defects  of  the  system,  Louis  XIII 
abandoned  it,  and  took  up  the  institutional  idea  his 


RECORD      OF      INJUSTICE  17 

father  before  him  had  essayed.  He  planned  generously, 
and  undertook  construction  in  1633.  This  new  venture 
was  destined  to  be  the  prototype  of  the  famous  Hotel 
des  Invalides,  the  idea  of  which  is  usually  attributed  to 
Louis  XIV. 

Very  little  is-  known  of  the  history  of  the  institution 
thus  established  by  Louis  XIIL  In  1646,  an  official 
report  declared  that  the  building  lodged  only  a  gate- 
keeper, a  pot-house,  and  the  architect  who  had  designed 
the  structure;  nowhere  was  there  a  soldier  to  be  found. 
Doors  and  windows  gaped,  the  roof  leaked.  In  1656, 
the  building  was  given  to  the  general  hospital  of  the 
Salp^triere,  which  used  it  for  the  aged  poor,  as  a  mad- 
house, and  as  a  prison. 

Louis  XIV  returned  to  the  pension  system,  combining 
with  it  the  plan  of  appointing  the  less  severely  disabled 
to  garrison  duty  in  the  frontier  towns.  But  there  these 
unfortunates  were  so  badly  off  that  they  declared  "they 
had  rather  beg  than  submit  to  the  posts  that  had  been 
assigned  them."  The  old  abuses  and  disorders  reap- 
peared. In  order  to  curb  them,  the  king  ordered  that 
all  disabled  soldiers  caught  begging  in  the  city  of  Paris 
were  to  be  hanged;  whoever  gave  them  alms  was  to  be 
fined  100  livres.  All  to  no  purpose.  The  situation  be- 
came critical;  to  solve  it,  Louis  XIV  revived  the  insti- 
tutional idea. 

The  establishment,  like  everything  else  undertaken  by 
Louis  XIV,  was  on  a  magnificent  scale.  It  was  to  house 
4,000  pensioners.  The  king  resorted  to  the  monasteries 
for  funds,  but  the  yield  was  inadequate.  In  1682  he 
decreed  that  on  every  livre  that  was  spent  for  military 
purposes  a  tax  of  two  deniers,  later  raised  to  three,  was 
to  be  contributed  to  the  support  of  the  soldiers*  home. 


18  THE      DISABLED      SOLDIER 

During  the  war  of  the  Spanish  Succession,  this  sum 
amounted  to  1,250,000  livres  a  year.  The  future  of  the 
institution  was  secure. 

All  in  all,  measured  by  the  ideals  of  its  time,  this  latest 
venture  was  a  great  success.  In  the  fourteen  years 
between  1676  and  1690,  over  5,000  soldiers  applied  for 
admission;   during  the  next  fourteen  years,  over  10,000. 

A  brief  description  of  the  Hotel  des  Invalides,  as  the 
institution  was  called,  is  desirable,  for  there  can  be  little 
doubt  that  it  served  as  the  inspiration,  if  not  the  model, 
for  the  soldiers'  homes  that  were  later  established  in 
most  civilized  countries. 

The  superannuated  and  the  infirm  constituted  the 
majority  of  the  population  of  the  Hotel.  On  the  eve  of 
the  Revolution,  over  a  century  after  its  establishment, 
out  of  3,000  inmates,  1,107  were  old  men  between  seventy 
and  ninety-two  years  of  age,  1,488  had  suffered  amputa- 
tions or  were  otherwise  wounded,  decrepit,  or  infirm,  of 
whom  72  were  provided  with  wooden  legs,  62  were  one- 
handed,  4  minus  both  arms,  203  blind,  2  with  silver 
noses,  129  on  crutches,  185  helpless,  and  68  idiots. 

The  house  was  organized  first  and  foremost  for  the 
care  of  the  aged  and  the  sick.  More  than  half  the  per- 
sonnel spent  all  their  days  in  the  infirmary,  looked  after 
by  sisters  of  charity.  A  comrade  was  assigned  to  each 
man  who  was  helpless  enough  to  need  constant  assist- 
ance, the  former  receiving  a  special  allowance  for  his 
pains. 

The  officers  ate  apart  in  special  dining-rooms;  the 
privates  ate  in  two  "shifts"  in  four  great  refectories.  Food 
was  good  and  plentiful,  including  daily  portions  of  meat, 
bread,  and  wine.  The  institution  provided  uniforms  and 
shoes,  and  a  pittance  of  fifteen  sous  a  month. 


RECORD      OF      INJUSTICE  19 

The  discipline  was  military;  the  Hotel  was  like  a  gar- 
rison. There  were  special  police,  gate-keepers,  sentinels. 
Everything  was  done  to  the  roll  of  drums.  Severe  mili- 
tary rule  was  supplemented  by  a  moral  discipline,  which 
provided  for  compulsory  attendance  at  Sunday  services, 
and  heavy  penalties  for  infractions  of  the  rules  against 
swearing,  intoxication,  fisticuffs. 

Amusements  were  rather  limited,  except  for  card- 
games  and  skittles.  Some  of  the  inmates  worked  little 
gardens.  They  were  all  permitted  to  work  in  their  rooms. 
The  administration  even  went  so  far  as  to  provide  tools 
and — for  those  who  cared  to  learn — instruction  in  a 
trade.  Those  who  were  married,  and  whose  families 
lived  in  the  neighborhood,  were  given  frequent  permis- 
sion to  visit  their  wives  and  children;  but  no  one  could 
marry  without  the  consent  of  the  governor. 

Certain  marks  of  honor  raised  the  institution  above 
the  level  of  a  mere  asylum;  but  personal  liberty  was 
greatly  reduced,  and  many  were  glad  to  leave  after  a 
short  stay. 

The  king  was  not  slow  to  notice  that  many  of  the 
disabled  soldiers  could,  at  a  pinch,  still  render  service, 
notably  on  garrison  duty  in  frontier  strongholds.  The 
Hotel  continued  to  clothe  and  feed  those  who  were 
selected  for  this  service,  and  gave  them  pay  or  half-pay. 
In  1736  there  were  141  of  these  "detached  companies." 
Those  who  found  life  in  the  Invalides  too  dull  asked 
nothing  better  than  to  be  assigned  to  this  service. 

Gradually  the  custom  grew  up  of  granting  three  years' 
leave  to  those  who  had  families  and  longed  to  live  with 
them,  during  which  time  the  Hotel  clothed  them  and 
gave  them  an  allowance  of  at  least  100  livres.  Soon  the 
three  years'  leave  was  extended  indefinitely,  the  allow- 


20  THE      DISABLED      SOLDIER 

ances  automatically  becoming  pensions.  In  1790,  in 
addition  to  2,370  disabled  men  in  the  institution  itself, 
there  were  throughout  France  26,000  pensioned  soldiers. 

Thus,  the  two  principles  of  institutionalism  and  pen- 
sions— principles  ultimately  adopted  by  all  the  western 
nations — came  to  exist  side  by  side  in  France,  continuing 
down  through  the  nineteenth  and  into  the  twentieth 
centuries.  In  1831  the  pension  system  was  revised  and 
regulated.  The  revised  law  based  the  pension  awards  on 
years  of  service,  on  rank  attained,  and  to  some  slight 
extent  on  the  seriousness  of  the  disability.  This  law 
was  still  operative  when  the  war  of  1914  began. 

Today,  the  Invalides  is  little  more  than  a  magnificent 
war  museum.  It  did  not  escape  severe  criticism  even 
in  its  palmiest  days.  Voltaire  regarded  it  as  constituting 
in  large  measure  a  source  of  waste,  holding  that  "the 
discharged  soldier  might  still  labor  and  follow  a  trade, 
and  give  children  to  his  country."  Another  French 
writer,  Ardant  du  Pic,  declared:  "The  Invalides  is 
superb  as  a  bit  of  apparatus,  of  ostentation.  I  wish 
that  the  original  inspiration  had  been  an  impulse  of 
justice,  a  Christian  idea,  and  not  purely  one  of  military 
policy;  nevertheless,  the  eflfects  are  morally  disastrous. 
This  assembly  of  idlers  is  a  school  of  depravity  in  which 
the  invalided  soldier  ultimately  forfeits  the  right  to  be 
respected." 

The  history  of  the  care  of  the  disabled  soldier  in 
France  is  largely  typical  of  the  history  of  this  movement 
in  other  countries.  In  most  nations,  the  administrative 
conscience  awoke  but  tardily  to  an  even  approximately 
adequate  sense  of  its  obligations  both  to  society  and  to 
the  individual  disabled  in  the  most  perilous  of  social 
functions.      It   will   be   remembered   that   in    England, 


RECORD      OF      INJUSTICE  21 

toward  the  close  of  the  sixteenth  century,  Queen  Eliza- 
beth took  ineffective  measures  for  the  relief  of  hun- 
dreds of  soldiers  who  had  been  invalided  home  from 
Flanders.  There  seems  to  be  no  record  of  further  public 
action  until  the  time  of  the  Commonwealth,  when  Par- 
liament made  more  effective  provision,  both  in  the  form 
of  pension  grants  and  of  soldiers'  hospitals  and  homes, 
but  only  for  those  soldiers  who  had  been  disabled  fighting 
for  Cromwell.  Crippled  royalists  received  no  consider- 
ation. When  these  partisan  provisions  were  revoked  by 
Charles  II  on  his  accession  to  the  throne,  the  hitherto 
neglected  royalist  soldiers  took  advantage  of  the  oppor- 
tunity to  plead  for  provisio'n.  And  in  1662  the  king 
approved  a  measure  enabling  discharged  soldiers  to 
practise  a  trade  without  completing  an  apprenticeship — 
a  measure  which  provided  but  sorry  relief  for  those  most 
in  need  of  care,  the  severely  disabled. 

In  1682,  however,  the  king,  prompted  by  the  need  of 
maintaining  a  considerable  force  and  inspired,  doubtless, 
by  the  magnificent  example  of  Louis  XIV  of  P>ance, 
issued  a  decree  for  the  establishment  of  the  Royal  Hos- 
pital at  Chelsea  for  disabled  soldiers.  About  the  same 
time  steps  were  also  taken  for  the  establishment  of  the 
Greenwich  Hospital  for  invalided  seamen.  Both  institu- 
tions were  carried  to  completion  under  William  and  Mary. 

Chelsea  Hospital  was  supported  chiefly  by  money 
compulsorily  deducted  from  the  soldiers'  pay.  Not  until 
the  nineteenth  century  did  Parliament  provide  more 
generously  for  the  maintenance  of  the  institution.  In 
addition  to  the  relief  provided  by  these  hospitals,  a  pen- 
sion system  was  inaugurated  shortly  after  the  opening  of 
both  establishments,  based  on  disability  incurred  during 
service   or   on    infirmity   after   twenty   years'    service. 


22 THE      DISABLED      SOLDIER 

Before  long  the  numbers  qualifying  on  this  basis  had  in- 
creased so  extensively  that  it  was  necessary  to  establish 
a  system  of  "out-pensioners,"  organized  into  "invalid 
companies"  and  liable  to  special  service  in  time  of  war. 

The  pension  system  was  subject  to  great  abuses,  the 
pensioners  generally  receiving  but  a  fraction  of  the  in- 
come (small  enough  in  itself)  they  were  legally  entitled 
to.  In  1754  William  Pitt  reformed  the  system,  "having 
it  much  at  heart  to  redeem  these  helpless  unthinking 
creatures  from  their  harpies." 

Oliver  Goldsmith,  in  one  of  his  essays,  quotes  a  dis- 
abled sailor  who  had  been  driven  to  begging  at  the 
outskirts  of  a  town  as  saying  to  him:  "As  for  my  mis- 
fortunes, master,  except  for  the  loss  of  my  limb,  and  my 
being  obliged  to  beg,  I  don't  know  any  reason,  thank 
Heaven,  that  I  have  to  complain.  Blessed  be  God,  I 
enjoy  good  health,  and  will  forever  love  liberty  and  Old 
England.    Liberty,  property,  and  Old  England,  Huzza!" 

Early  in  the  nineteenth  century.  Parliament  passed 
an  act  granting  pensions  to  all  soldiers  who  were  inva- 
lided, disabled,  or  discharged  after  from  fourteen  to 
twenty-one  years  of  service.  Since  then,  and  especially 
after  the  South  African  War,  the  system  has  been  gen- 
erously extended,  including  relief  not  only  for  disabled 
and  retired  soldiers,  but  also  for  the  widows  and  orphans 
of  those  dying  in  service. 

It  is  pleasant  to  be  able  to  say  that  no  nation  has 
hitherto  been  so  generous  in  its  provision  for  the  disabled 
soldier  as  the  United  States  of  America.  In  fact,  the 
first  relief  measures  were  undertaken  very  shortly  after 
the  founding  of  the  early  colonies.  Plymouth  Colony  was 
founded  in  1620;  it  passed  its  first  pension  legislation 
in  1636,  providing  that  any  man  who  should  be  sent 


Cliu  of  il,  hUvM  lr,^ilfui    thmat  llijl  DaircmJln   CtuftLn  i,mUf .  viil  Jun„r,  U,JI . 

(jut  miti  al  CruibiU,    of  liyJt  ffim  Du  cm  Kn  vi»(  fcoi  ,  im  riititm  tl<(u»K  mj4M 


A  Procession  of  Cripples,  by  Jerome  Bosch,  a  fifteenth 
century  painter  who  had  a  predilection 
for  taking  cripples  as  his  subjects 


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The  Disabled  Sailor  Approaches  Oliver  Goldsmith. 
A  Reproduction  from  a  plate  in  an  1809 
edition  of  Goldsmith' s  works 


RECORD      OF      INJUSTICE  23 

forth  as  a  soldier  and  return  maimed  was  to  be  main- 
tained competently  the  rest  of  his  life.  Eight  years  later, 
the  Virginia  Assembly  passed  a  disability  pension  law, 
and  not  long  thereafter  another  law  creating  a  system 
of  relief  for  the  needy  dependents  of  any  colonist  killed 
in  the  service  of  the  colony. 

Long  before  the  Revolution,  other  colonies  had  taken 
similar  measures,  Rhode  Island  not  only  providing  pen- 
sions for  the  disabled  and  for  the  dependents  of  those 
killed  in  service,  but  also  decreeing  that  every  wounded 
soldier  was  entitled  to  medical  care  at  the  colony's  ex- 
pense until  cured. 

A  few  months  after  the  beginning  of  the  Revolution 
the  Continental  Congress  declared  that  half-pay  would 
be  allowed  every  officer,  soldier,  and  sailor  incapacitated 
during  the  war.  However,  since  the  Continental  Con- 
gress possessed  neither  funds  nor  any  real  powers,  the 
pension  obligations  incurred  by  this  and  by  similar  reso- 
lutions rested  solely  upon  the  several  states,  some  of 
which  repudiated  them. 

Several  times  during  the  bitter  struggle,  at  critical 
moments  when  the  outlook  was  gloomiest  and  the  army 
discouraged,  General  Washington  appealed  to  the  Con- 
gress for  more  generous  pension  provisions.  The  oppo- 
sition to  these  proposals  was  always  strong.  A  provision 
granting  officers  somewhat  more  favorable  schedules 
than  those  set  up  for  the  men  was  violently  denounced 
as  undemocratic. 

The  first  general  pension  law  enacted  under  the  Con- 
stitution was  passed  in  1792  and  amended  the  following 
year.  In  its  amended  form  it  provided  that  five  dollars 
monthly  (raised  to  eight  dollars  twenty-three  years  later) 
was  to  be  paid  all  privates  and  non-commissioned  officers 


24  THE      DISABLED      SOLDIER 

disabled  in  the  service  of  the  Continental  Army.  In- 
capacitated officers  were  allowed  half-pay. 

This  measure  furnished  the  model  for  the  regular 
army  pensions  law  that  was  passed  in  1802  and  which 
continued  unaltered  in  its  essentials  down  to  the  Civil 
War.  At  various  times  throughout  the  first  half  of 
the  nineteenth  century  special  pension  legislation  for 
special  groups,  such  as  the  widows  of  the  Revolutionary 
soldiers,  was  enacted,  the  details  of  which  need  not  be 
here  discussed.  During  the  Civil  War  the  principle  of 
fixed  rates  for  specific  disabilities — the  loss  of  a  hand, 
the  loss  of  a  foot,  both  hands,  both  feet,  both  eyes,  etc. — 
was  introduced,  a  principle  which  has  since  found  fruitful 
application  not  only  in  military  but  also  in  industrial 
legislation.  In  1870  it  was  enacted  that  artificial  limbs, 
renewable  every  five  years  at  public  cost,  be  provided. 

In  general,  the  tendency  since  the  Civil  War  has  been 
in  the  direction  of  unusual  liberality.  There  is  no  need 
here  for  recording  this  legislation  in  detail.  It  is  suffi- 
ciently well  known  to  everybody  that  in  some  directions 
the  system  has  been  extravagantly  extended,  so  that,  in 
the  words  of  an  American  general,  "It  has  come  to  pass 
that  those  who  were  merely  on  the  rolls  for  a  few  days, 
and  the  malingerers  and  the  deserters  all  march  as 
veterans  of  the  great  conflict." 

One  other  feature  deserves  mention,  however.  This 
feature  is  the  state  and  federal  Soldiers'  Homes.  The 
former  number  in  excess  of  thirty,  all  told;  in  some  of 
them  the  wives,  mothers,  widows,  sisters,  or  daughters  of 
the  beneficiaries  are  maintained,  as  well  as  the  disabled 
and  invalided  soldiers  themselves.  The  total  number  of 
individuals  maintained  in  these  state  institutions  is 
about  11,000.    The  federal  institutions  are  two  in  num- 


RECORD      OF      INJUSTICE  25 

ber,  both  situated  in  the  District  of  Columbia.  One  of 
these,  the  National  Home  for  Volunteer  Soldiers,  has  ten 
branches  in  various  parts  of  the  country.  The  number 
cared  for  in  the  federal  homes  has  varied  between  18,000 
and  30,000. 

The  lot  of  the  industrial  worker  who  is  disabled  by 
accident  has  in  the  past  been  very  unfortunate.  Up  to 
a  few  years  ago  he  had  no  redress  except  through  the 
courts  and  the  employer  had  many  technical  defenses 
which  could  be  offered.  For  the  most  part  the  injured 
man  slipped  back  in  the  social  scale  and  frequently 
became  dependent  on  relatives,  or  friends,  or  on  public 
charity. 

Even  after  the  recent  advent  of  compensation  legisla- 
tion which  has  done  much  to  remedy  the  injustices  in- 
volved in  industrial  accidents,  the  situation  has  not  been 
greatly  improved  because  while  the  money  compensation 
went  to  support  the  man  during  the  period  of  idleness 
ensuing  the  accident,  it  did  nothing  constructive  to  put 
him  back  on  his  feet  again  and  to  restore  him  to  useful 
employment.  Too  often  the  man  has  lived  on  his  com- 
pensation as  long  as  it  lasted  and  when  it  expired  been 
forced  to  appeal  for  charitable  assistance.  Amputations 
and  other  injuries  are  great  economic  levelers,  and  it  has 
been  found  in  several  studies  that  the  skilled  worker 
before  the  accident  has  been  reduced  after  it  to  em- 
ployment as  peddler,  messenger,  or  watchman.  In  this 
process  a  vast  deal  of  potential  ability  and  productive- 
ness has  been  lost  to  the  community. 

This  statement  gains  force  when  it  is  considered  that 
in  eighteen  states  alone  there  are  being  injured  in  industry 
over  750,000  men  per  year.  Over  35,000  of  these  acci- 
dents represent  permanent  disability  either  partial  or 


26  THE      DISABLED      SOLDIER 

total.  It  is  estimated  by  competent  authority  that  the 
permanent  disabilities  produced  annually  through  indus- 
trial accident  in  all  the  states  number  over  80,000  of 
which  over  2,000  represent  total  disability  and  over 
28,000  amputation  cases. 

Up  to  modern  times,  therefore,  the  cripple  has  been 
always  an  object  of  charity  if  not  of  actual  neglect  and 
mistreatment.  Public  opinion  has  conceived  the  cripple 
as  helpless  and  almost  insisted  that  he  become  so. 
Charity  has  been  readily  proffered,  but  almost  never  the 
opportunity  to  make  good  and  get  back  on  his  own  feet. 
Educational  advantages  have  been  closed  to  the  dis- 
abled man ;  the  employer  has  refused  him  a  job. 

Successful  cripples  are  unanimous  in  evidence  to  the 
effect  that  the  greatest  handicap  is  not  a  loss  of  limb  or 
other  disability  but  the  weight  of  public  opinion.  They 
have  had  to  fight  constantly  against  it  in  order  to  make 
their  way  and  assume  a  useful  place  in  the  work  of  the 
world. 

Even  the  social  workers  who  have  a  natural  interest 
in  all  the  unfortunate  classes  have  been  forced  practically 
to  give  up  the  crippled  man.  There  have  been  sporadic 
attempts  in  various  large  cities  to  operate  employment 
bureaus  for  the  physically  handicapped,  but  in  almost 
every  instance  the  work  was  given  up  because  it  was  im- 
possible to  get  employers  to  take  men  and  because  for 
disabled  men  who  needed  training  prior  to  placement 
there  was  no  possibility  of  obtaining  the  requisite  edu- 
cational opportunity. 

For  decades  every  indication  has  pointed  to  the  need 
of  special  training  facilities  for  the  disabled.  But  the 
community  did  not  see  fit  to  provide  them. 


BREAKS      IN      THE      WALL  27 

CHAPTER  II 

BREAKS  IN  THE  WALL 

About  the  first  move  of  a  constructive  character  look- 
ing toward  putting  disabled  men  back  on  their  feet  must 
be  credited  to  Belgium.  In  1908  there  was  founded  at 
Charleroi  in  the  Province  of  Hainaut  a  school  and  shop 
for  men  crippled  in  industrial  accidents.  It  was  pointed 
out  by  a  public  spirited  lawyer,  Paul  Pastur,  that  it 
was  better  to  train  the  disabled  for  work  which  they 
could  perform  than  to  be  content  with  paying  them 
compensation  and  permitting  them  to  remain  in  idleness. 
The  subjects  taught  to  the  adult  pupils  in  this  Belgian 
school  were  bookbinding,  shoe  repairing,  tailoring,  sad- 
dlery, harness-making,  and  clerical  work.  There  were 
likewise  shops  for  the  seriously  disabled  and  older  men 
for  the  making  of  grass  carpet  and  baskets. 

Beginning  one  month  after  admission  to  the  classes 
or  shops  the  workers  were  paid  a  small  stipend,  and  if 
they  persevered  and  remained  over  six  months  they 
received  pay  for  the  first  month  as  well. 

This  pioneer  experiment  proved  successful  and  the 
institution  flourished. 

In  1897  there  was  established  in  Petrograd,  in  connec- 
tion with  the  Maximilian  Hospital,  a  shop  for  the  manu- 
facture of  orthopedic  apparatus  and  for  the  training  of 
cripples  in  this  trade.  Later  other  equipment  was 
acquired,  and  in  1901  residential  facilities  were  estab- 
lished. Training  has  been  given  in  the  making  of  ortho- 
pedic   appliances,    rug-making,    shoemaking,     cabinet- 


28  THE      DISABLED      SOLDIER 

making,  turning,  brush -making,  willow  work,  weaving 
and  needlework,  saddlery,  and  tailoring.  Cripples  be- 
tween the  ages  of  fourteen  and  thirty  are  received  for 
instruction,  and  the  average  course  of  training  is  four 
years  in  length.  During  the  Russo-Japanese  War  the 
workshop  was  considerably  enlarged. 

After  the  South  African  War  there  were  established 
in  Great  Britain  by  the  Incorporated  Soldiers  and  Sailors' 
Help  Society  workshops  for  the  employment  of  disabled 
soldiers. 

There  were  established  in  France  in  1899  by  M.  Mar- 
soulan,  under  the  auspices  of  the  Department  of  the 
Seine,  subsidized  workshops  for  cripples  and  incurables 
of  both  sexes.  The  occupations  carried  on  are  the 
making  of  grass  carpet,  chair-caning,  toy-making,  and 
the  like.  These  shops  are  more  in  the  nature  of  relief 
agencies  than  training  schools. 

A  school  similar  in  character  to  the  one  at  Charleroi 
was  organized  by  the  Belgian  province  of  Brabant  just 
prior  to  the  outbreak  of  the  present  war.  Its  plans  were 
completely  drawn  and  its  equipment  acquired,  when  the 
German  invasion  interrupted  the  enterprise. 

The  advent  of  a  new  era  for  the  disabled  man,  however, 
was  marked  by  the  establishment  in  Lyons,  France,  in 
December  1914  by  Edouard  Herriot,  mayor  of  the 
city,  of  the  first  training  school  for  invalided  soldiers. 
M.  Herriot  found  it  difficult  to  reconcile  the  number  of 
disabled  men,  strong  and  well  with  the  exception  of 
their  specific  handicap,  who  were  sunning  themselves  in 
the  streets  and  public  squares  in  the  city,  with  the  des- 
perate need  for  labor  in  the  local  munition  factories. 
His  first  impulse  was  to  find  jobs  for  these  men,  but  he 
soon  learned  that  the  men  who  were  unemployed  were 


BREAKS      IN      THE      WALL  29 

those  so  handicapped  as  to  be  disqualified  from  returning 
to  their  former  occupation.  Before  they  could  be  re- 
stored to  employment  they  must  needs  be  trained  in 
some  trade  compatible  with  their  handicap. 

But  a  few  months  after  the  declaration  of  war — to  be 
specific  on  November  30,  1914 — Mayor  Herriot  asked 
consent  from  the  municipal  council  of  Lyons  to  establish 
a  training  school  for  the  mutiUs  de  la  guerre.  On  De- 
cember 16,  a  little  over  two  weeks  later,  the  school 
opened  its  doors  and  in  the  picturesque  statement  of 
French  origin,  "The  Mayor  welcomed  the  first  three 
pupils,  grasping  them  by  their  three  hands."  The  school 
was  housed  in  an  eighteenth  century  building  which 
belonged  to  the  city.  The  pupils  registered  in  ever  in- 
creasing numbers  and  so  great  was  the  need  that  before 
long  the  old  building  in  the  Rue  Rachais  was  outgrown. 
An  annex  to  the  school  was  therefore  established  on  a 
farm  property  at  the  outskirts  of  the  city.  Soon  after 
its  foundation,  the  original  school  was  christened  the 
£cole  Joffre  and  the  new  branch  was  designated  as  the 
ficole  de  Tourvielle.  Both  schools  soon  outgrew  their 
accommodations.  By  October  of  the  first  year  of  oper- 
ation, it  was  necessary  to  turn  applicants  away.  There 
was  faced  dther  the  necessity  of  further  enlarging  the 
plant  or  saying  to  the  men  injured  in  the  recent  combats 
in  Artois  and  Flanders:  "We  are  sorry  but  you  were 
wounded  too  late."  The  authorities  at  Lyons  decided 
that  they  would  not  submit  this  excuse  and  at  once  de- 
cided to  build  new  pavilions  and  open  new  courses. 

The  schools  are  open  to  soldiers  whose  disability 
is  such  as  to  entitle  them  to  pension.  Men  from  any 
part  of  France,  from  the  colonies,  and  from  the  allied 
nations  are  accepted  as  pupils,  but  preference  is  given 


30  THE      DISABLED      SOLDIER 

to  those  residing  in  the  vicinity  of  Lyons  or  in  the  in- 
vaded sections  of  France. 

The  length  of  course  ranges  from  six  to  eighteen 
months.  Instruction,  board,  lodging,  and  clothing  are 
furnished  without  charge  and  no  deduction  is  made  from 
any  pension  which  may  have  been  awarded.  Pupils  not 
receiving  pensions  or  allowances  are  paid  by  the  school 
twenty  cents  a  day  for  pocket  money.  The  proceeds 
from  the  sale  of  work  produced  by  the  shops  is  discounted 
fifteen  per  cent,  for  running  expenses  and  the  balance 
divided  among  the  pupil  workers  according  to  their  pro- 
ductive capacity. 

At  the  school  in  the  city  are  taught  clerical  work,  which 
comprises  bookkeeping,  stenography,  and  typewriting; 
paper-box-making  and  bookbinding;  toy-making,  and 
beadwork.  At  the  suburban  branch  are  taught  shoe- 
making,  galoche-making,  tailoring,  carpentry  and  cabi- 
net-making, fur  work,  manufacture  of  artificial  limbs 
and  orthopedic  appliances,  wireless  telegraphy,  and  horti- 
culture. Instruction  in  shop  work  in  the  manufacture 
of  artificial  limbs  has  been  found  most  successful.  The 
shop  renders  services  which  are  considered  indispensable. 
It  studies  the  needs  of  the  workmen  in  the  different 
trades,  designs  useful  appliances  for  them,  and  produces 
any  special  device  needed  for  a  given  purpose.  The 
trade  is  appropriate  for  men  who  have  worked  with 
either  wood,  metal,  or  leather,  and  has  recruited  its 
pupils  from  the  ranks  of  men  who  were  mechanics, 
blacksmiths,  wood  and  metal  turners,  harness-makers, 
plaster  workers,  and  shoemakers  before  the  war. 

The  course  in  fur  work  was  started  at  the  request  of 
a  number  of  fur  merchants  of  the  city  of  Lyons  who 
were  concerned  over  the  shortage  of  workmen  in  their 


Where  There's  a  Will.     With  both  arms  gone,  this  poilu  has  found 
a  way  to  do  useful  work  again.    He  was  taught  at  Lyons, 
where  the  pioneer  schools  of  re-education  were  founded 


BREAKS      IN      THE      WALL  31 

trade.  They  considered  it  a  sound  business  measure  as 
well  as  a  humane  and  patriotic  duty  to  create  a  supply 
of  trained  furriers  to  take  the  place  of  the  Germans 
hitherto  almost  exclusively  employed.  The  school  was 
glad  to  open  such  a  course,  since  the  work  can  be  done 
seated  and  is  therefore  suitable  for  men  with  amputated 
or  paralyzed  legs.  A  committee  composed  of  five  of 
the  leading  fur  merchants  of  the  city  aided  the  school  in 
organizing  the  course  by  inviting  visits  to  their  shops, 
by  furnishing  plans,  and  by  selecting  a  foreman.  After 
the  class  was  started,  they  continued  their  cooperation; 
they  supplied  skins  on  which  the  pupils  could  work, 
paid  them  for  their  work,  and  promised  definite  posi- 
tions to  those  who  finished  the  course. 

A  wireless  telegraphy  section  was  started  at  Tourvielle 
as  a  result  of  a  conversation  between  M.  Herriot  and 
Colonel  Ferrie,  technical  director  of  wireless  telegraphy 
in  the  Army.  Colonel  Ferrie  regretted  the  lack  of  good 
operators  and  at  a  time  when  wireless  stations  were 
being  multiplied  so  rapidly.  "So  you  want  operators?" 
queried  the  Mayor  of  Lyons,  "Good!  I  will  provide 
them." 

A  few  days  later,  a  complete  school  of  wireless  teleg- 
raphy had  been  organized  at  Tourvielle.  Pupils  were 
easily  recruited;  teachers  were  found  in  the  Seventh 
Regiment  of  Engineers,  and  equipment  was  obtained 
from  the  radio  service  of  Lyons.  Without  waiting  for 
accommodations  to  be  built,  the  class  started  in  a  little 
room  in  the  main  building  which  at  other  times  was 
used  as  a  smoking  and  reading-room.  The  pavilion 
afterwards  built  for  the  purpose  is  divided  into  five 
rooms — two  private  rooms  for  the  teachers,  a  large  class- 
room, a  sound-reading  room,  and  an  instrument  room. 


32  THE      DISABLED      SOLDIER 

Poles  and  antennae  of  the  most  modern  type  have  been 
set  up  outside. 

In  1915  M.  Herriot  laid  down  the  rule,  "The  school- 
teacher should  be  the  first  instructor  engaged  by  a  school 
for  the  wounded."  Tourvielle  has  from  the  beginning 
had  a  school-teacher,  and  evening  classes  in  school  sub- 
jects have  been  held  regularly  from  seven  to  eight  every 
evening  except  Thursdays  and  Sundays.  Classes  are 
formed  by  grouping  the  pupils  according  to  their  pre- 
vious education  and  their  needs.  The  illiterate  have 
lessons  in  reading,  writing,  and  arithmetic,  while  the 
more  advanced  listen  to  lectures  on  different  subjects. 

These  two  schools  at  Lyons  have  proved  the  inspiration 
of  and  an  example  for  over  a  hundred  similar  schools 
for  disabled  soldiers  established  throughout  the  French 
Republic. 

In  all  the  other  belligerent  countries  movements  were 
soon  under  way  to  restore  disabled  soldiers  to  self- 
support. 

Belgium,  under  necessity  of  founding  the  institution 
on  foreign  soil,  organized  a  school  for  the  training  and  a 
factory  for  the  employment  of  disabled  soldiers. 

Great  Britain  was  slow  in  starting,  but  has  now 
worked  out  a  satisfactory  system  for  re-educating  her 
disabled  men. 

Italy  followed  very  closely  after  the  example  of  France 
and  now  has  a  series  of  local  schools  under  the  direction 
of  a  central  committee  at  Rome, 

Throughout  Germany  there  have  been  started  by 
private  and  local  initiative  schools  or  training  centers. 

Canada  and  the  other  British  dominions  recognized 
their  duty  to  the  men  disabled  in  the  war  and  set  up 
public  bodies  to  deal  with  the  problem.    And  finally  the 


BREAKS      IN      THE      WALL  33 

United  States  has  followed  and  will  attempt  to  improve 
upon  the  example  set  by  the  other  belligerents. 

"America,  too,  I  know,"  writes  John  Galsworthy, 
"new  as  yet  to  this  conflict  and  the  wreckage  thereof. 
Of  that  great  warm-hearted  nation,  I  prophesy  deeds  of 
restoration,  most  eager,  most  complete  of  all."  May 
that  generous  prediction  in  generous  measure  be  fulfilled. 

During  a  period  of  little  over  three  years  the  disabled 
soldier  has  come  into  his  own  and  instead  of  being  com- 
pletely neglected  is  now  offered  thorough  and  modern 
facilities  for  training  which  will  restore  him  to  an  inde- 
pendent and  self-respecting  position  in  the  community." 


34  THE      DISABLED      SOLDIER 


CHAPTER  III 

ORDERS  TO  ADVANCE 

The  soldier  who  has  done  his  duty  in  military  service, 
has  been  wounded  and  permanently  disabled,  must  not 
after  discharge  from  the  army  resign  himself  to  depen- 
dence on  his  pension  and  to  spending  the  rest  of  his 
life  in  demoralizing  idleness.  He  must  still  continue  to 
do  his  duty.  He  has  made  good  on  the  field  of  action 
and  he  must  make  good  again  in  the  field  of  civilian 
endeavor,  even  though  handicapped  through  his  patri- 
otic service,  A  line  of  one  of  our  national  anthems 
refers  to  the  sounding  of  "the  trumpet  that  shall  never 
call  retreat,"  and  in  spite  of  his  wounds,  the  disabled 
soldier  must  not  lose  his  courage  and  retire  from  the 
front  line  of  endeavor.  He  now  receives  from  his  country 
very  definite  orders  still  further  to  advance  and  he  has 
yet  before  him  opportunity  to  prove  himself  a  good 
soldier  and  a  worthy  citizen. 

Now  that  nations  have  seen  the  light  and  are  making 
effort  to  repair  the  injuries  done  their  disabled  soldiers 
in  the  past,  the  men  themselves  must  play  their  part 
and  help  in  every  way  possible  to  further  the  pro- 
gram. 

One  of  the  greatest  aids  in  putting  the  disabled  soldier 
back  on  his  feet  is  drawn  from  the  example  of  men  who 
have  successfully  taken  advantage  of  the  training  oppor- 
tunities. In  Great  Britain  the  Minister  of  Pensions  has 
issued  a  booklet  entitled,  "What  Every  Disabled  Soldier 
Ought  to  Know"  and  which  contains  letters  from  men 


ORDERS      TO      ADVANCE  35 

who  have  graduated  through  training  to  success  in 
civilian  employment. 

In  schools  for  blind  soldiers  one  of  the  principal  func- 
tions is  performed  by  blind  men  themselves  who  receive 
the  newcomers  and  encourage  them  to  start  off  with 
ambition  to  make  their  way  under  their  new  handicap. 

Most  lasting  help  is  derived  from  the  example  of 
civilian  cripples  who  under  the  great  handicap  of  public 
opinion  in  the  past  and  with  every  disadvantage  against 
them  have  made  good.  By  force  of  superior  character 
and  initiative  these  men  have  overcome  the  same  physical 
handicaps  under  which  their  less  forceful  fellows  have 
gone  down  to  economic  defeat.  At  one  school  for  dis- 
abled men,  one  of  the  most  helpful  features  has  been  a 
series  of  meetings  for  an  audience  of  cripples,  addressed 
by  crippled  speakers.  One  of  these  speakers  was  a  man 
whose  extremities  had  been  frozen  by  exposure  in  a 
blizzard,  with  consequent  amputation  of  two  legs,  one 
arm,  and  four  fingers  of  the  remaining  hand.  He  had 
then  become  for  two  years  an  inmate  of  the  poor-house. 
He  told  the  county  authorities  that  if  they  would  give 
him  just  one  year  in  college,  he  would  never  again  cost 
them  a  cent,  persuaded  them  to  do  so,  and  made  good 
his  prediction.  He  later  rose  to  be  speaker  of  the  House 
of  Representatives  in  his  home  state,  and  is  now  presi- 
dent of  a  flourishing  bank  in  the  middle  west.  "If 
your  mind  and  spirit  are  straight,"  he  says,  "no  other 
handicap  can  keep  you  down." 

Another  speaker  had  one  leg  amputated  and  started 
under  this  handicap  with  no  educational  or  financial 
advantages  whatever.  The  best  job  he  could  get  was  as 
a  shipping  clerk,  but  he  soon  found  there  was  no  future 
for  a  disabled  man  in  a  manual  and  unskilled  job.    Under 


36  THE      DISABLED      SOLDIER 

great  difficulty,  he  attended  night  school,  and  finally 
obtained  modest  employment  under  civil  service  auspices. 
He  now  occupies  a  position  requiring  a  high  degree  of 
expertness  and  experience. 

A  third  successful  cripple  who  spoke  at  one  of  these 
meetings  was  a  man  who  had  lost  both  arms  in  an  acci- 
dent; one  is  amputated  at  the  shoulder,  the  other  just 
below  the  elbow.  He  found  almost  hopeless  difficulty 
in  getting  the  first  job,  becoming  meanwhile  almost  a 
vagrant.  At  last  he  obtained  employment  supervising 
a  gang  of  unskilled  laborers.  From  that  point  he  has 
risen  steadily.  He  has  invented  and  manufactured  his 
own  appliances,  with  the  aid  of  which  he  does  practically 
every  duty  of  daily  routine — including  putting  on  his 
collar  and  tie,  engaging  in  a  game  of  bowling,  or  pruning 
his  own  peach  trees.  He  was  elected  by  his  county  to 
be  justice  of  the  peace  and  later  was  thrice  chosen  for 
the  responsible  task  of  county  judge. 

Such  indomitable  courage  in  the  face  of  adverse 
circumstances  cannot  fail  of  inspiration  to  other  men 
handicapped  in  the  same  ways.  The  disabled  men 
themselves  urge  their  fellows  to  obey  the  new  order 
to  advance. 


TO      SELF-SUPPORT  37 

CHAPTER  IV 

FIRST  STEPS  TO  SELF-SUPPORT 

With  the  medical  department  of  the  military  organi- 
zation lies  the  first  responsibility  and  by  all  odds  the 
greatest  task  in  dealing  with  the  disabled  soldiers.  A 
very  large  proportion — about  eighty  per  cent. — of  the 
men  handled  through  the  hospitals  overseas  successfully 
recover  and  return  to  the  front  for  further  service. 

Of  those  returned  from  overseas  almost  ninety  per 
cent,  are  candidates  for  physical  reconstruction  only. 
About  twenty  per  cent,  are  permanently  disabled,  par- 
tially or  totally.  Half  of  this  number,  however,  are  able 
to  go  back  to  their  former  occupation,  without  the  need 
of  re-education.  The  other  half,  or  ten  per  cent,  of  those 
dealt  with  by  the  reconstruction  hospital,  require  special 
training. 

It  will  be  evident,  therefore,  that  the  task  of  caring 
medically  and  surgically  for  the  injured  soldier,  is  one  of 
immense  magnitude.  It  has  taxed  to  the  limit  the 
facilities  of  the  medical  corps  of  our  allies,  and  in  pro- 
viding for  similar  work  in  this  country,  the  Surgeon 
General  of  the  Army  will  need  and  deserve  the  unstinted 
financial  support  of  the  legislative  authorities  and  moral 
support  of  the  people  as  a  whole. 

The  reason  why  this  job  of  physical  reconstruction  of 
wounded  men  has  not  received  wider  public  attention 
is  that  the  marvels  of  medicine  and  surgery  are  not 
entirely  new  to  us,  while  the  economic  reconstruction 
of  the  tithe  of  the  total  who  would  otherwise  be  destined 

119763 


38  THE      DISABLED      SOLDIER 

for  the  social  scrap  heap  is  of  very  recent  development, 
and  has  seized  upon  the  public  imagination.  Yet  without 
the  work  of  the  medical  corps,  re-education  would  lack 
a  sound  foundation  on  which  to  build. 

In  the  reconstruction  hospital  of  the  present  day,  the 
injured  soldier  receives  not  only  the  standard  and  routine 
treatment  but  also  attention  from  specialists,  such  as  is 
available  under  ordinary  circumstances  to  the  rich  man 
only.  This  intensive  treatment  continues  as  long  as 
there  is  room  for  improvement.  During  its  course  occu- 
pational work  with  a  therapeutic  object  plays  a  r61e  of 
surprising  importance. 

The  current  conception  of  a  hospital  pictures  a  large 
ward  with  rows  of  white  beds  along  both  sides,  and  with 
the  occupants  of  the  cots  lying  quietly  back  on  the 
pillows  waiting  to  get  well.  One  can  imagine  the  state 
of  mind  such  an  existence  would  engender.  Every  worry, 
every  apprehension,  every  symptom  possible  of  adverse 
interpretation  would  get  one  hundred  per  cent,  attention 
from  the  patient.  And  in  competition  with  this  mental 
concentration  on  self  and  self's  ills,  there  is  nothing  but 
the  once-daily  perfunctory  statement  of  the  doctor: 
"You  are  getting  on  very  well." 

That  a  worried  and  fretful  mental  state  has  an  injurious 
reflex  upon  the  course  of  an  invalid's  recovery  is  well 
known.  Any  means,  therefore,  by  which  the  mind  may 
be  occupied  and  directed  to  some  other  object  than  the 
patient's  own  ills  may  be  expected  to  have  beneficial 
results. 

Experience  has  shown  that  one  of  the  most  effective 
curative  agents  at  the  disposition  of  the  physician  is 
occupation.  Simple  work  of  the  hands  can  be  started 
while  the  patient  is  still  ill  in  bed,  and  increased  in 


TO      SELF-SUPPORT  39 

amount  and  consequence  during  the  period  of  conva- 
lescence. So  in  recent  years  teachers  of  "occupational 
therapy"  or  of  "bedside  occupations"  have  come  to  form 
part  of  the  staff  of  the  best  civil  hospitals,  and  in  the 
military  hospitals  they  are  now  considered  a  necessity. 

From  the  point  of  view  of  mental  therapy  it  matters 
little  what  lines  of  occupation  are  offered,  provided  they 
interest  the  men.  The  more  fascinating  and  engrossing 
the  work,  the  better  the  mental  results  attained.  There 
must  be  some  product  in  which  the  patients  will  take 
satisfaction — which  perhaps  they  can  take  away  at  the 
end  of  their  stay  in  the  hospital — for  without  product 
interest  cannot  be  long  sustained. 

From  the  point  of  view  of  physical  therapy,  it  is 
desirable — other  things  being  equal — that  the  manual 
exercise  involved  shall  contribute  to  the  process  of 
physical  restoration.  If  a  man  with  injured  fingers  can 
be  set  at  an  occupation  which  will  bring  the  fingers 
actively  into  use,  more  will  be  gained  than  by  many 
periods  of -massage.  The  same  principle  applies  to  the 
more  extended  occupational  work  after  the  bedside  stage. 

While  primarily  curative  in  object,  the  choice  of  sub- 
jects should  also  be  considered  from  the  economic  point 
of  view — though  not  to  the  prejudice  of  the  physical 
results.  A  man  is  to  be  a  long  period  in  the  hospital, 
and  during  his  stay  is  to  be  occupied.  If  the  simple 
experience  and  training  can  serve  to  brush  up  his  skill 
in  or  extend  his  knowledge  regarding  the  employment 
to  which  he  will  return,  so  much  the  better.  In  other 
words,  his  hospital  occupation  should  be  as  purposeful 
as  possible. 

In  the  early  days  of  occupational  therapy,  the  subjects 
were  largely  limited  to  those  of  the  kindergarten :  bead- 


40  THE      DISABLED      SOLDIER 

work,  basket  weaving,  knitting,  clay  modelling,  and  the 
like.  These  are  now  coming  to  be  added  to  and  in  many 
cases  supplanted  by  more  consequential  ones  such  as 
typewriting,  weaving  of  textiles,  mechanical  drafting, 
telegraphy,  and  it  will  be  the  duty  of  those  carrying 
forward  this  work  to  add  still  further  to  the  list.  For 
the  foreign  speaking  or  the  illiterate  the  teaching  of 
English  is  another  excellent  subject  for  hospital  in- 
struction. 

If  the  patient  understands  the  work  to  be  useful  he 
will  enter  upon  it  with  more  enthusiasm  and  vigor,  and 
the  results  will  be  proportionately  improved.  When  the 
activity  can  in  any  way  be  related  to  the  man's  future 
job  its  import  becomes  even  greater.  It  is  hardly  fair 
to  keep  a  man  knitting  when  he  may  as  advantageously 
take  up  some  more  masculine  and  practical  occupation. 
These  principles  are  coming  more  and  more  to  be  realized 
by  the  military  medical  authorities. 

One  of  the  most  interesting  branches  of  the  medical 
work  has  as  its  aim  the  restoration  of  function — over- 
coming limitation  of  movement  in  joints,  re-training 
muscles,  and  the  like.  This  work  is  usually  known  as 
"functional  re-education." 

The  modern  principle  is  that  the  exercises  to  restore 
the  impaired  function  shall  be  active  operations  by  the 
patient,  rather  than  passive  manipulations  by  hand  or 
machine.  At  Hart  House,  in  Toronto,  Canada,  there  is 
in  progress  most  interesting  work  of  this  character.  All 
of  the  instruments  have  registering  dials  so  that  the 
disabled  man  can  see  from  day  to  day  to  what  angle  of 
motion,  through  his  own  effort,  he  attains.  The  visible 
improvement  encourages  him,  and  the  showing  on  the 
dial  is  a  constant  incentive  to  excel  his  previous  record. 


TO      SELF-SUPPORT  41 

The  process  brings  the  patient  face  to  face  with  his  dis- 
ability, and  leads  him  to  concentrate  upon  the  effort  to 
overcome  it.  The  man  thus  learns  the  habit  of  self- 
treatment  and,  even  outside  of  regular  treatment  periods, 
does  what  he  can  to  further  his  recovery. 

Another  type  of  treatment  to  restore  function  consists 
in  prescribed  work  in  a  curative  workshop,  a  method 
already  initiated  in  the  more  simple  occupational  ac- 
tivity. If  he  has  a  stiff  elbow  the  soldier  is  set  to  work 
at  a  machinist's  bench  and  in  the  interest  developed  in 
the  work  in  hand,  uses  the  file  so  as  to  give  the  joint 
highly  effective  exercise.  In  this  instance  the  active 
exercise  with  a  therapeutic  end  is  unconscious — ^just  the 
reverse  of  the  situation  in  using  the  registering  machines 
already  described.  The  man  hardly  realizes,  in  his  in- 
terest in  the  work  itself,  the  curative  object  in  view. 
One  obvious  advantage  is  that  the  exercise  desired  can 
be  kept  up  most  of  the  day,  which  would  be  impossible 
with  a  more  formal  system  of  treatment. 

In  the  words  of  the  officer  in  charge  of  one  of  the  British 
military  orthopedic  hospitals:  "If  you  give  a  man  a  damp 
rag  and  set  him  at  work  cleaning  windows  you  will  see 
that  he  is  continually  working  his  fingers  as  though 
grasping  a  spring  dumb-bell.  But  while  he  would  tire 
of  the  dumb-bell  in  a  few  minutes,  he  will  clean  windows 
for  several  hours  without  excessive  fatigue."  The  man 
busy  sawing  a  piece  of  wood  going  to  make  up  the  frame- 
work of  a  piece  of  theatrical  scenery  is  really  engaged  in 
working  an  injured  elbow  back  to  health.  The  carpenter 
planing  so  vigorously  has  nothing  manifestly  the  matter 
with  his  hands;  in  matter  of  fact  he  has  a  stiff  ankle, 
but  as  he  works  he  thrusts  forward  his  right  leg  with 
each  move  in  order  to  get  more  power  into  his  stroke, 


42  THE      DISABLED      SOLDIER 

and  in  so  doing  unconsciously  works  his  lame  ankle  all 
the  time. 

Games  and  recreation  play  another  important  r61e  in 
the  curative  process.  They  furnish  a  form  of  uncon- 
scious exercise  for  stiff  joints  and  muscles.  The  compe- 
tition and  enjoyment  are  also  factors  of  positive  value, 
bowling,  quoits,  badminton,  hand-ball,  billiards,  and 
tennis  have  all  found  place  in  the  program  of  recon- 
struction hospitals  and  convalescent  homes. 

When  physician,  nurse,  and  hospital  aid  have  done 
everything  possible  to  advance  the  physical  well-being 
of  the  wounded  soldier,  and  it  becomes  evident  that  in 
spite  of  them  all  he  will  be  permanently  handicapped, 
the  attack  on  his  individual  problem  veers  its  direction. 
A  plan  for  his  future  which  will  lead  to  usefulness  and 
self-support  must  be  laid  out.  More  accurately  the  man 
himself  must  determine  upon  a  plan  for  his  own  future, 
though  he  may  be  helped  and  guided  to  it  by  friendly 
counsel. 

The  first  difficulty  is  encountered  in  the  acute  de- 
pression and  discouragement  entailed  in  the  serious  dis- 
ablement of  a  healthy  vigorous  man — for  the  men  on 
the  fighting  line  are  physically  the  flower  of  the  com- 
munity. He  knows  the  fate  of  his  friends  or  fellow- 
workmen  who  have  in  the  past  been  crippled,  blinded, 
or  otherwise  injured.  They  have  gone  down  many  rungs 
on  the  social  and  economic  ladder.  The  man  who  was 
a  machinist  became  a  messenger,  the  electrical  worker 
became  a  watchman,  the  skilled  baker  now  peddles 
pretzels,  and  the  plumber  now  sells  shoestrings  on  the 
street  corner.  Is  it  any  wonder  the  outlook  to  the 
newly  disabled  man  does  not  look  bright? 


TO      SELF-SUPPORT  43 

Again,  it  seems  to  him  as  though  life  would  hold  no 
pleasure  in  the  future,  and  that  he  will  always  feel  sen- 
sitive regarding  his  handicap.  Besides  nobody  has  much 
use  for  the  disabled.  And  these  deductions  have  much 
basis  in  precedent  and  observation. 

This  state  of  mind  will  be  encountered  in  the  invalided 
soldier.  It  must  be  met  early — in  the  base  or  special 
hospital  abroad — and  overcome.  Arguments  drawn  from 
the  black  past  history  of  the  disabled  must  be  outweighed 
by  those  drawn  from  the  hopeful  experience  of  modern 
practice.  With  returning  health,  initiative  must  be  re- 
awakened, responsibilities  quickened,  a  heartened  ambi- 
tion must  replace  discouragement.  We  can  go  to  him 
and  truthfully  say:  "If  you  will  help  to  the  best  of  your 
ability,  we  will  so  train  you  that  your  handicap  will  not 
prove  a  serious  disadvantage ;  we  will  prepare  you  for  a 
job  at  which  you  can  earn  as  much  as  in  your  previous 
position.  Meantime  your  family  will  be  supported  and 
maintained.  Finally,  we  will  place  you  in  a  desirable  job." 

To  this  end  it  is  vital  that  doctors,  nurses,  and  aids 
in  the  military  hospitals  abroad  shall  have  a  full  realiza- 
tion of  the  principles  and  practice  of  "reconstruction." 
They  must  be  able  to  visualize  to  the  man  his  future 
opportunities  and  possibilities  so  that,  from  the  first, 
every  contact  and  influence  may  operate  to  encourage 
rather  even  than  to  countenance  despair. 

During  the  period  of  depression  the  only  point  of 
comfort  is  dependence  on  the  pension  which  becomes 
the  due  of  every  disabled  soldier  and  sailor.  The  man 
begins  to  figure  on  how  he  will  manage  to  exist  on  the 
stipend  which  he  will  receive.  And  in  most  instances  a 
small  stipend  it  is  indeed.  In  the  United  States  the 
scale  is  the  most  generous  of  any  country  in  the  world. 


44  THE      DISABLED      SOLDIER 

Granted  a  constructive  and  effective  program  for  the 
reconstruction  of  the  disabled  soldier  and  sailor,  a  low 
pension  scale  may  be  a  blessing  in  disguise,  in  that  it 
may  force  the  men  to  make  plans  for  support  through 
their  own  efforts.  Their  first  reaction,  however,  when  a 
constructive  plan  is  presented  is  fear  that  increasing 
their  earning  power  may  jeopardize  their  pensions,  and 
a  reluctance — until  the  pension  is  determined — to 
undertake  any  instruction  which  would  improve  their 
economic  status. 

The  success  of  any  system  of  re-education  is  contingent 
upon  a  very  clear  understanding  that  pensions  will  not 
be  so  prejudiced.  Most  of  the  countries  at  war  an- 
nounced that  pensions  were  determined  by  physical 
condition  alone.  It  was  further  stated  that  a  man  could 
take  training  and  go  out  to  earn  more  wages  than  he 
was  paid  as  an  able-bodied  workman  before  enlistment 
and  yet  have  his  pension  undisturbed.  This  did  not 
sound  credible  to  the  men,  however,  and  the  facts  had  to 
be  stated  again  and  again.  In  all  the  Canadian  hospitals, 
convalescent  homes,  and  training  schools  placards  setting 
forth  this  principle  relating  to  pensions  are  prominently 
displayed. 

The  only  country  to  delay  definite  statement  on  this 
point  was  Great  Britain,  and  her  early  re-educational 
work  was  greatly  handicapped  thereby.  But  in  the  most 
recent  British  pensions  warrant  a  soldier  totally  disabled 
in  military  or  naval  service  receives  for  his  lifetime  the 
sum  of  275.  (id.  per  week.  In  proportion  to  rank  this 
sum  is  increased.  For  pension  rating  a  man  is  accounted 
totally  disabled  if  he  has  lost  two  or  more  limbs,  a  limb 
and  an  eye,  the  sight  of  both  eyes,  or  incurred  other 
stated  disabilities.    He  is  regarded  as  being  eighty  per 


TO      SELF-SUPPORT  45 

cent,  disabled — and  thus  entitled  to  eighty  per  cent,  of 
the  total  disability  pension — if  he  has  suffered  the  loss 
of  both  feet,  a  leg  at  the  hip,  a  right  arm  at  the  shoulder, 
or  the  loss  of  speech.  A  short  amputation  of  the  thigh, 
the  loss  of  a  left  arm  at  the  shoulder  or  of  right  at  or 
above  the  elbow  is  regarded  as  a  seventy  per  cent,  dis- 
ablement. The  scale  proceeds  through  a  schedule  of 
disabilities  down  to  a  twenty  per  cent,  disability,  for 
which  one-fifth  of  the  total  disability  rate  is  paid.  For 
lesser  injuries  the  man  is  paid,  once  and  for  all,  a  lump 
sum,  termed  a  gratuity. 

The  warrant  states  that  "when  a  permanent  pension 
has  been  granted  it  shall  not  be  altered  on  account  of 
any  change  in  the  man's  earning  capacity,  whether  re- 
sulting from  training  or  other  cause."  A  certain  injury, 
therefore,  means  a  certain  pension,  and  there  is  no 
authority  with  discretion  to  decrease  the  amount. 
When  this  was  once  clearly  understood  it  made  all  the 
difference  in  the  world  in  the  attitude  of  the  men  toward 
re-educational  proposals.  Many  men  who  have  been 
trained  are,  with  both  their  wages  and  pension,  better 
off  financially,  than  before  their  injury.  For  a  man  with 
both  legs  off,  from  the  economic  point  of  view  clearly 
is  not  totally  disabled,  and  even  without  a  pension  might 
earn  more  than  before  his  enlistment  in  the  army. 

With  the  pension  difficulty  out  of  the  way,  we  must 
return  to  the  effort  to  have  the  man  decide  to  carry  on 
to  self-support.  There  are  several  considerations  per- 
tinent to  his  decision. 

First  is  the  attraction  of  the  temporary  war  job. 
Under  the  abnormal  labor  conditions  existing  in  time  of 
war  even  a  disabled  man  can  go  out  and  get  employ- 
ment at  an  amazing  wage.    That  such  a  job  is  temporary, 


46  THE      DISABLED      SOLDIER 

that  it  has  no  future,  and  that  it  affords  no  experience  of 
value  are  truths  only  evident  on  second  thought.  They 
must  be  clearly  demonstrated  to  the  wounded  man. 

In  the  second  place  the  soldier  has  been  long  from  the 
routine  and  responsibilities  of  the  civilian  community. 
His  life  has  been  one  of  danger  and  excitement,  but  as 
related  to  the  ordinary  functions  of  existence  has  been 
automatic,  regulated  in  every  particular.  A  man  will 
view  with  reluctance  a  return  to  the  responsibilities  of 
a  voluntary  enterprise,  such  as  his  course  of  training 
will  be. 

In  illustration  of  this  state  of  mind  Major  John  L. 
Todd,  of  Canada,  cites  the  case  of  a  returned  officer  who 
found  it  difficult  to  make  up  his  mind  in  the  ordering  of 
a  meal  from  a  menu  placed  before  him.  "A  civilian  is 
accustomed  to  order  his  meals,  to  do  everything  for 
himself.  He  goes  into  the  army  and  serves  four  years, 
during  which  time  all  his  meals  are  chosen  for  him.  The 
hour  when  he  should  go  to  his  meals  is  decided  for  him. 
Suddenly  wounded,  he  is  no  longer  fit  to  be  a  soldier, 
and  turned  out  into  the  world  to  unlearn  just  those 
things  which  have  been  taught  him  with  such  pains 
and  effort." 

With  regard  to  the  reluctance  to  take  up  again  a  reg- 
ular routine,  it  can  be  argued  that  a  man  must,  sooner 
or  later,  re-assume  his  civilian  responsibilities,  and  that 
this  will  be  much  easier  and  more  satisfactory  if  he  has 
prepared  to  meet  them. 

The  third  consideration  is  that  the  soldier  has  been 
away  from  home  for  a  long  period,  and  his  most  urgent 
desire  is  to  get  back  to  his  family  and  friends.  Against 
this  desire,  a  discussion  of  prospects  for  the  future  does 
not  seem  to  carry  much  weight.    Tactful  persuasion  of 


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TO      SELF-SUPPORT  47 

the  man,  however,  supported  by  the  encouragement  that 
the  social  workers  dealing  with  the  family  are  able  to 
inspire  can  often  effect  the  right  result. 

And  finally  is  the  tendency  of  the  disabled  soldier  to 
conceive  that  he  has  done  his  duty  by  his  country  and 
that  he  should  now  be  supported  for  the  rest  of  his 
natural  days  at  national  expense.  This  is  largely  a 
question  of  personal  character.  The  weak  and  shiftless 
come  easily  to  this  servile  point  of  view,  the  strong  and 
self-dependent  shun  it  vigorously.  Again,  the  family 
influence  will  often  be  the  deciding  factor,  and  this  can 
be  largely  moulded  by  the  home  service  visitors.  The 
adviser  in  the  hospital  has  here  a  job  in  character  building 
and  it  will  be  found  that  this  type  of  effort  is  essential 
all  through  the  rehabilitation  process. 

Final  decision  on  all  these  points  of  consideration  will 
depend  in  large  degree  on  the  caliber  of  the  men  who  as 
advisers  are  put  in  touch  with  the  disabled  soldiers. 
Personal  strength  and  force  are  at  a  premium.  The 
strong  man  will  make  a  success  of  this  preliminary  work 
— the  average  man  will  fail.  If  it  should  be  asked  what 
is  the  greatest  need  of  the  disabled  soldier  the  answer 
would  be — not  industrial  school  equipment,  not  elabo- 
rate courses,  not  splendid  buildings — but  the  finest  men 
the  country  affords  to  help  him  in  the  critical  period 
immediately  following  disablement.  Where  there  is 
found  exceptionally  successful  work  with  injured  soldiers, 
there  will  be  found  a  man  of  unusual  qualifications.  In 
Great  Britain  experience  has  shown  the  need  for  picking 
most  carefully  the  executive  secretary  of  local  war  pen- 
sions committees  to  deal  with  disabled  soldiers  and 
sailors,  for  upon  the  man  chosen  turns  the  success  or 
failure  of  work  in  the  district. 


48  THE      DISABLED      SOLDIER 

It  is  to  be  hoped  that  the  one  place  where  a  re-educa- 
tional organization  will  not  economize  is  in  the  salaries 
of  the  men  to  become  the  friends  and  advisers  of  the 
disabled  soldiers.  No  precedent,  no  existing  scale  of 
payment,  no  red  tape  must  interfere  with  taking  for 
this  work  the  pick  of  our  human  resources.  Such  an 
injustice  to  the  returning  service  men  could  never  be 
condoned. 


THE   NEW   SCHOOLHOUSE       49 

CHAPTER  V 

THE  NEW  SCHOOLHOUSE 

Once  the  disabled  soldier  has  made  the  decision  to 
carry  on,  he  should  be  given  the  advantage  of  a  course 
of  training  wisely  planned  and  capably  executed. 

The  plan  of  re-education  is  to  train  a  man  for  a  job 
in  which  he  can  perform  one  hundred  per  cent,  efficiently 
in  spite  of  his  handicap,  to  find  a  process  in  the  perform- 
ance of  which  the  disability  will  be  no  drawback  what- 
ever. With  the  wide  variety  of  industrial  processes 
today,  it  is  entirely  possible,  with  care  and  ingenuity, 
to  find  specific  jobs  which  men  with  all  types  of  handicap 
can  follow.  For  the  man  with  serious  leg  injury,  there 
is  sought  a  seated  job;  for  the  man  with  arm  injury, 
work  which  can  be  done  with  one  hand  only;  for  the 
man  with  lung  difficulty,  outdoor  employment;  for  the 
blind  man,  work  in  which  the  senses  of  hearing  and 
touch  are  the  primary  essentials.  . 

For  even  the  most  seriously  disabled  cases,  well-paid 
jobs  can  be  found.  The  manner  in  which  the  problem 
is  approached  can  best  be  illustrated  by  several  specific 
instances.  A  man  with  both  legs  off,  if  trained  thoroughly 
as  a  linotype  operator,  can  hold  down  his  job  and  deliver 
as  much  product  as  his  fellow  workman  with  sound  legs. 
He  comes  to  work  in  the  morning,  sits  down  on  his  chair, 
and  need  not  get  up  from  it  until  the  close  of  the  working 
day.  The  work  is  all  done  by  his  hands.  In  this  job  is 
such  a  man  disabled? 


50  THE      DISABLED      SOLDIER 

A  man  with  one  arm  is  trained  as  a  painter  and  given 
a  job  in  a  furniture  factory  striping  chairs,  for  which  work 
he  would  use  only  one  hand,  even  if  both  were  sound. 

The  man  with  lungs  weakened  by  tubercular  infection, 
gassing,  or  exposure,  can  be  trained  as  a  chauffeur  and 
found  a  job  at  which  he  is  in  the  open  air  all  the  time. 
In  this  way,  his  health  is  protected  and  his  disability 
practically  offset. 

The  blind  man  can  be  trained  to  assemble  the  parts 
of  small  machinery.  He  is  given  the  component  parts 
on  a  bench  at  which  he  is  seated  and,  beginning 
with  the  frame,  adds  part  after  part  in  regular  sequence. 
Is  this  man  at  any  disadvantage  in  comparison  to  his 
sighted  colleague? 

Yet  all  these  jobs  are  well-paid,  and  disabled  men  can 
be  trained  for  them  without  difficulty.  Preparation  for 
them  restores  self-respect  in  that  the  man  does  not  have 
to  ask  favors  in  seeking  employment  of  such  skilled 
character. 

It  is  not,  of  course,  entirely  easy  to  find  just  the  job 
which  men  of  different  types  of  handicap  should  follow. 
Work  of  this  kind  is  entirely  new,  and  training  in  the 
highly  skilled  lines  has  not  been  attempted  in  the  past 
by  those  who  have  been  concerned  in  the  education  or 
placement  of  disabled  men.  Industry  must  therefore 
be  examined  in  the  most  thorough  and  comprehensive 
manner  in  order  that  the  jobs  sought  may  be  disclosed 
to  the  training  and  placement  authorities. 

One  of  the  best  means  to  this  end  is  the  conduct  of 
industrial  surveys  with  the  aim  of  disclosing  employ- 
ment opportunities  for  the  physically  handicapped.  In 
fact  such  surveys  are  essential  to  intelligent  work  for  the 
disabled. 


THE      NEW      SCHOOLHOUSE  51 

When  the  British  Pensions  Ministry  took  over  the  re- 
sponsibility of  training  disabled  soldiers  for  self-support, 
an  arrangement  was  effected  with  the  Department  of 
Labor  to  make  studies  of  openings  in  industry  for  dis- 
abled men.  Each  industry  was  considered  by  a  com- 
mittee which  was  familiar  with  its  possibilities,  and  the 
findings  of  this  committee  were  published  for  the  benefit 
of  local  training  officials. 

Up  to  date  these  committee  reports  cover  attendants 
at  electricity  sub-stations;  employment  in  picture 
theatres;  custom  tailoring;  agricultural  motor  tractor 
work;  furniture  trade;  leather  goods  trade;  hand-sewn 
custom  boot  and  shoe  making  and  repairing;  gold,  silver, 
jewelry,  watch  and  clock  jobbing;  dental  mechanics; 
aircraft  manufacture;  wholesale  tailoring;  boot  and  shoe 
manufacture;  basket-making  trade;  building  trade;  en- 
gineering; printing  and  kindred  trades;  picture  frame 
making. 

The  most  complete  investigations,  however,  have  been 
carried  out  in  Canada  under  the  Vocational  Branch  of 
the  Invalided  Soldiers'  Commission.  Whole  industries 
have  been  surveyed  at  first  hand  by  competent  investi- 
gators who  bore  in  mind  the  needs  of  the  soldiers  in  whose 
behalf  the  information  was  gathered.  Before  the  work 
was  started,  a  classification  was  made  of  the  various  dis- 
abilities which  would  be  met  with,  and  the  availability 
of  the  trades  to  men  with  these  handicaps  was  carefully 
recorded.  In  every  report  will  be  found  a  statement 
regarding  the  suitability  of  the  trade  for  leg  cases,  arm 
cases,  the  deaf,  and  so  forth. 

The  surveys  also  comprised  a  full  statement  of  the 
method  and  practice  of  the  industry,  so  that  placement 
agents  and  vocational  ofiicers  might  have  a  very  clear 


52  THE      DISABLED      SOLDIER 

and  succinct  idea  of  the  trade  requirements  for  which 
men  are  being  prepared. 

In  the  United  States  some  small  beginnings  have  been 
made  on  similar  work.  It  was  found  by  the  employment 
department  of  the  Red  Cross  Institute  for  Crippled  and 
Disabled  Men  that  there  was  needed  more  accurate 
knowledge  regarding  the  possibility  of  getting  jobs  for 
cripples  in  the  leading  industries  of  the  city.  Investi- 
gators were  sent  out  in  a  very  informal  way  to  look  into 
the  openings  in  various  trades  and  report  back  upon 
their  observations.  Over  forty  industries  have  already 
been  studied  in  this  way,  among  them  the  piano,  leather, 
rubber,  paper  goods,  shoe,  sheet  metal  goods,  candy, 
drug  and  chemical,  cigar,  silk,  celluloid,  optical  goods, 
and  motion  picture  industries.  Similar  work  on  a  more 
ambitious  scale  has  now  been  undertaken  by  the  Harvard 
Bureau  of  Vocational  Guidance,  which  has  started  with 
examinations  of  coppersmithing,  the  shoe  industry,  and 
rubber  manufacture. 

Industrial  surveys  of  the  character  described  serve 
three  specific  ends: 

1.  They  show  in  what  specific  jobs  the  individual  dis- 
abled man  can  be  placed.  If  the  man  has  general  experi- 
ence in  some  trade,  it  is  possible  for  the  placement  officer, 
who  could  not  otherwise  know  in  detail  the  circumstances 
in  a  particular  occupation,  to  send  out  the  applicant  with 
a  good  idea  of  what  job  he  should  apply  for  and  with  a 
very  clear  conception  as  to  whether  he  is  competent  to 
hold  it  down. 

2.  It  gives  educational  officers  a  good  idea  as  to  the 
lines  in  which  disabled  men  can  be  placed  for  training 
in  factories  or  mercantile  establishments  under  the 
apprenticeship  method. 


THE      NEW      SCHOOLHOUSE  53 

3.  The  surveys  oftentimes  discover  subjects  which 
are  desirable  for  school  instruction  of  disabled  men.  As 
a  matter  of  fact,  when  any  particular  line  is  under 
consideration  for  addition  to  the  curriculum  of  a  school, 
one  of  the  best  criteria  of  desirability  is  a  thorough  in- 
dustrial survey  of  the  trade  for  which  the  course  will 
prepare. 

The  actual  experiences  of  cripples  who  have  been  em- 
ployed in  various  trades  will,  if  recorded,  afford  valuable 
data  for  the  placement  of  other  disabled  men.  In  one 
employment  bureau,  it  is  the  practice  to  ask  every  cripple 
in  considerable  detail  regarding  his  employment  record. 
If  he  found  one  trade  possible  with  his  disability  or 
another  one  out  of  the  question  by  reason  of  his  handi- 
cap, these  data  are  recorded  and  provide  a  good  basis 
for  dealing  with  another  cripple  of  approximately  the 
same  handicap  and  experience. 

In  picking  out  the  subjects  of  instruction  for  a  training 
school  among  those  which  surveys  of  the  trades  have  dis- 
closed as  possible  for  the  employment  of  handicapped 
men,  selection  should  be  made  according  to  the  following 
criteria : 

1.  The  trade  should  pay  well,  as  otherwise  it  will 
hardly  profit  the  soldier  to  take  a  thorough  course  of 
training  to  prepare  for  it.  It  is  frequently  found  that 
among  trades  which  require  almost  equal  ability  and 
training,  one  will  pay  good  wages  and  the  other  will  pay 
poorly,  due  to  commercial  influences  of  one  kind  or 
another  or  to  labor  conditions. 

2.  It  is  necessary  to  pick  out  a  trade  which  is  growing 
rather  than  on  the  wane.  In  other  words  it  must  be  one 
in  which  there  is  constant  demand  for  a  new  supply  of 
skilled  labor.    Such  a  condition  will  insure  steady  em- 


54  THE      DISABLED      SOLDIER 

ployment  and   the  prompt  absorption   into   the  labor 
market  of  graduates  from  the  training  course. 

3.  Trades  which  are  seasonal  in  character  should  be 
avoided.  The  placement  of  a  disabled  man  is  a  fairly 
expert  and  careful  job  and  it  should  not  be  repeated  any 
oftener  than  is  absolutely  necessary. 

4.  The  trades  selected  as  instruction  subjects  should 
be  teachable  and  should  not  depend  in  too  large  degree 
upon  native  ability  or  talent.  For  example,  some  of 
the  artistic  or  craft  lines  require  almost  an  artist's 
ability, and  among  a  large  number  of  disabled  men,  there 
might  be  only  one  who  could  possibly  take  advantage 
of  the  training. 

5.  And  the  trades  must  be  teachable  within  a  reason- 
able length  of  time.  While  men  may  be  willing  to  defer 
for  some  months  their  return  to  regular  employment, 
they  will  not  have  patience  for  a  long  period.  Being 
adults,  they  would  feel  some  of  the  best  years  of  their 
life  were  slipping  away  from  them  and  that  the  training 
was  not  worth  the  cost.  At  many  schools  in  France 
instruction  in  tailoring  had  to  be  given  up  because  it 
required  eighteen  months  to  bring  a  man  to  the  point  of 
proficiency,  and  the  soldiers  would  not  wait  that  long. 

6.  The  occupations  for  which  training  is  given  must 
not  be  those  in  which  there  must  be  expected  labor  dis- 
turbance or  over-supply  at  the  termination  of  the  war. 
It  would  be  hard,  for  example,  to  find  an  employment 
better  suited  to  a  one-legged  man  than  automobile 
driving.  Yet  the  British  Pensions  Ministry  has  sent  out 
instructions  that  no  disabled  men  are  to  be  trained  for 
this  work.  The  explanation  is  that  motor  transport  has, 
in  the  present  war,  displaced  the  army  mule,  and  that 
tens  of  thousands  of  enlisted  men  have  been  trained  to 


THE      NEW      SCHOOLHOUSE  55 

drive  the  automobile  trucks.  These  men  are  receiving 
the  most  versatile  experience  a  chauffeur  could  have,  and 
at  demobilization  they  will  be  turned  out  into  the  civilian 
labor  market  to  seek  employment.  The  disabled  man 
should  not  be  submitted  to  this  unusual  competition. 

In  actual  practice  the  most  popular  trade  being  taught 
to  crippled  soldiers  is  "motor  mechanics,"  that  is,  the 
operation  and  repair  of  automobile  engines.  Too  popu- 
lar the  school  directors  think  it,  for  almost  every  man 
asked  to  express  his  preference  as  to  subject  elects  to 
train  as  a  motor  mechanic.  There  could  be  no  better 
proof  that  the  automobile  still  has  glamour  in  the  public 
eye.  The  work  manifestly  appeals  to  the  men's  imagina- 
tions, and  they  want  to  go  into  it  whether  their  ability 
lies  in  that  direction  or  not.  So  the  job  of  the  vocational 
director  is  to  dissuade  many  from  this  first  and  seemingly 
universal  choice.  Otherwise,  according  to  one  authority, 
"all  the  disabled  soldiers  in  Canada  would  be  garage 
workers,"  and  there  would,  of  course,  be  available  em- 
ployment for  but  a  few  of  them. 

The  aim  of  the  courses  is  to  train  repair  men  for 
garages  rather  than  chauffeurs.  A  specialized  branch  of 
automobile  mechanics  is  the  operation  of  agricultural 
tractors,  an  infant  branch  of  the  motor  industry,  but  a 
growing  one.  Geographical  influences  determine  this 
specialization.  Whereas  a  motor  class  in  Montreal  will 
work  with  commercial  trucks  and  pleasure  cars,  a  similar 
class  in  a  western  province  of  Canada  will  take  its  training 
on  farm  tractors. 

The  various  branches  of  electrical  work  offer  another 
good  field  of  instruction.  In  London  the  Institution  of 
Electrical  Engineers,  in  cooperation  with  Northampton 
Institute,  arranged  courses  to  train  switchboard  attend- 


56  THE      DISABLED      SOLDIER 

ants  for  electric  power  houses,  the  classes  being  open 
free  to  disabled  soldiers.  The  success  of  this  work  was 
proved  by  the  employment  of  every  man  the  day  his 
course  was  completed.  At  other  points  in  England  war 
cripples  are  taught  armature  winding,  magneto  as- 
sembling, inside  electrical  wiring,  and  general  repair 
work.  In  Germany  there  is  electrical  training  at  various 
centers,  notably  at  the  great  school  in  Diisseldorf.  There 
is  little  instructional  work  along  this  line  in  France. 
Electrical  trades  have  the  advantage  of  great  industrial 
stability.  They  are  growing  steadily,  the  wages  are  good, 
andtheemployment  is  not  subject  to  seasonal  fluctuation. 

Another  popular  subject  of  instruction  is  moving  pic- 
ture operation.  This  work  is  well-paid  and  fascinating 
as  well.  The  employment  demand  seems  unlimited  as 
the  number  of  "movie"  houses  is  growing  every  day. 
The  training  comprises  simple  work  in  electrical  wiring, 
and  operation  of  the  projecting  machines.  Some  of  the 
latter  now  run  by  motor,  do  not  require  the  grinding  of 
a  crank,  and  can  thus  be  handled  by  men  with  certain 
arm  injuries. 

To  pass  to  a  subject  of  another  kind,  cobbling  has 
been  found  a  good  trade  to  teach  a  certain  type  of  man. 
It  is  especially  suitable  for  leg  cripples.  In  large  cities 
a  reasonable  number  of  men  can  be  placed  in  shoe  re- 
pairing shops,  but  in  the  smaller  communities  and  in 
the  rural  districts  the  returned  soldier  can  set  up  business 
for  himself  and  build  up  a  good  trade.  The  required 
mechanical  equipment  is  simple,  and  can  be  rented 
rather  than  purchased  outright.  This  subject  is  taught 
in  practically  every  country  providing  vocational  re- 
education, but  is  particularly  popular  in  France  where 
it  is  represented  at  Paris,  Lyons,  Marseilles,  Bordeaux, 


THE      NEW      SCHOOLHOUSE 57 

Cherbourg,  Havre,  Limoges,  Montpellier,  Rouen,  Tou- 
louse, and  at  dozens  of  smaller  centers  throughout  the 
country.  Some  of  the  French  cripples  combine  with 
cobbling  the  repair  of  sandals  and  wooden  sabots. 

The  making  of  artificial  limbs  and  orthopedic  appli- 
ances has  been  found  a  good  trade  in  which  to  instruct 
war  cripples,  and  it  is  certainly  as  appropriate  a  line  as 
any  in  which  a  maimed  man  could  engage.  This  fitness 
is  more  than  theoretical  for  most  of  the  leg  makers  today 
are  men  who  are  themselves  minus  one  or  both  of  their 
lower  limbs.  In  addition  the  trade  is  in  a  boom  condition 
at  the  present  time  due  to  the  extraordinary  demand 
for  limbs  for  crippled  soldiers. 

The  number  of  trades  being  taught  is  legion.  Their 
choice  is  usually  dictated  by  the  labor  needs  of  the  com- 
munities in  which  the  particular  school  is  located. 
Among  those  which  have  found  fairly  general  adoption 
are  tailoring,  printing,  telegraphy,  machine  tool  work, 
sheet  metal  work,  and  toy-making. 

To  illustrate  the  combination  of  trades  taught  at  any 
individual  school,  the  list  of  courses  at  a  few  of  them 
may  be  of  interest.  At  Montpellier  are  taught:  shoe- 
making,  tailoring,  carpentry  and  cabinet-making,  var- 
nishing, wood-turning  and  carving,  metal-turning,  me- 
chanics, tinsmithing,  harness-making,  binding,  dental 
mechanics,  hair-dressing,  the  manufacture  of  artificial 
limbs,  operation  and  repair  of  automobiles,  industrial 
design,  and  bookkeeping; 

At  Diisseldorf:  metal  work,  mechanical  engineering, 
telegraphy,  electrical  work,  carpentry,  cabinet  work, 
wood-turning  and  carving,  locksmithing,  sculpture,  stone- 
cutting,  painting,  paper-hanging  and  plastering,  printing, 
photography  and  etching,  cardboard  work,  leather  work, 


58  THE      DISABLED      SOLDIER 

bookbinding,  dental  mechanics,  farming,  stenography, 
typewriting,  bookkeeping; 

At  the  Montreal  Technical  School:  drafting,  motor 
mechanics,  civil  service,  business,  English  and  French, 
stenography,  carpentry,  French  polishing,  pattern- 
making,  electric  wiring,  mathematics. 

After  possible  and  favorable  subjects  of  instruction 
have  been  selected,  however,  it  still  remains  to  fit  the 
individual  to  a  trade.  For  doing  this  there  are  no  gen- 
eral rules,  and  for  ten  cases  of  exactly  the  same  handicap 
there  will  be  ten  different  industrial  decisions.  The 
matter  is  determined  principally  by  the  past  occupa- 
tional experience  of  the  soldier.  He  is  a  man,  not  a  boy, 
and  his  education  has  been  gained  more  in  employment 
than  in  school.  The  new  beginning  is  made,  therefore, 
with  a  certain  vocational  preparation  which  must  not 
be  wasted.  The  aim  is  to  synthesize  preparation  for  the 
future  from  two-thirds  former  experience  and  one-third 
re-education  designed  to  utilize  that  experience  under 
the  new  conditions  of  physical  handicap. 

This  rule  has  been  followed  universally  by  the  re- 
education authorities  in  all  the  countries  at  war.  The 
Germans  report  ability  to  return  all  but  one  man  out  of 
twenty-five  to  his  own  line  or  one  closely  related.  In 
this  way  training  requirements  are  minimized,  and  the 
man  has  the  best  possible  foundation  for  his  new  start 
in  the  world  of  industry  and  employment. 

A  few  examples  can  show,  superficially  at  least,  the 
way  this  works  out.  A  freight  trainman  who  has  left  a 
leg  behind  him  in  the  base  hospital  is  not  in  shape  to 
return  to  his  old  job.  Let  us  presume  that  studies  by  the 
vocational  authorities  have  shown  that  operating  the 
keyboard  of  a  type-composing  machine  is  an  excellent 


THE      NEW      SCHOOLHOUSE 59 

trade  for  a  leg  cripple — as  it  is.  Shall  the  disabled  train 
hand  be  re-educated  as  a  machine  compositor?  The 
answer  is  emphatically  no,  for  in  this  event  all  his  rail- 
way experience  would  go  into  the  discard.  Special  con- 
siderations not  indicating  to  the  contrary,  however,  the 
amputated  soldier  may  be  trained  as  a  telegraph  operator 
and  sent  back  on  the  railroad  to  employment  in  a  switch 
tower  or  the  train  despatcher's  office,  in  either  of  which 
positions  all  his  familiarity  with  rolling  stock,  train 
schedules,  and  general  railway  practice  will  stand  him 
in  good  stead. 

There  is  added  advantage  in  such  a  case  that  the  man 
can  be  referred  for  work  to  his  former  employer  who  is 
fully  acquainted  with  his  record  as  to  reliability  and 
faithfulness.  All  the  employer  need  then  require  is  a 
certificate  of  the  veteran's  proficiency  in  his  new  r61e. 

On  the  other  hand,  presume  a  man  who  had  been  a 
hand  compositor  in  a  printing  office  came  home  with 
serious  leg  disability  which  precluded  for  the  future  his 
holding  a  standing  job.  Should  this  man  be  trained  as 
a  telegrapher,  which  proved  a  good  trade  for  the  other 
leg  cripple?  But  again  the  answer  is  negative,  for  the 
precious  print  shop  experience  would  be  wasted.  Train- 
ing as  a  proofreader,  however,  would  put  it  to  good  use. 

Some  men  may  be  raised  another  peg  in  their  own 
trade,  and  their  employment  education  thus  conserved. 
A  building  carpenter,  who  may  suffer  from  one  of  the 
thousand-and-one  disabilities  which  are  not  apparent, 
who  is  so  weakened  physically  that  he  cannot  go  back 
to  work  handling  beams  and  joists,  can  be  trained  in 
architectural  drafting  and  the  interpretation  of  plans 
and  prepared  for  a  position  as  a  foreman  or  inspector  of 
construction.     His  former  experience  will  be  the  best 


60  THE      DISABLED      SOLDIER 

possible  preparation  for  this  job,  for  he  will  know  all 
the  tricks  of  the  trade,  and  very  little  will  get  by 
him. 

An  educator  in  one  of  the  allied  countries  has  pointed 
out  that  very  frequently  disabled  men  who  have  taken 
advantage  of  training  go  out  to  better  paid  jobs  than 
they  held  before  their  injury.  The  position  in  any  given 
line  that  requires  less  physical  capacity  usually  is  the 
one  that  requires  more  skill  and  head-work,  and  as  such, 
carries  with  it  higher  earning  power. 

The  disabled  farmer  is  somewhat  of  a  special  case,  but 
he  too  should  not  abandon  the  occupation  in  which  he 
is  experienced.  If  he  cannot  return  to  pitching  hay,  he 
can  be  trained  for  poultry  raising,  dairy-work,  bee 
keeping,  or  other  of  the  lighter  agricultural  specialties. 
He  will  then  not  be  subjected  to  the  revolutionary  change 
involved  in  transporting  a  confirmed  countryman  to 
industrial  work  in  a  large  city — conditions  under  which 
he  is  extremely  likely  to  be  unhappy. 

There  is  another  reason  why  the  agriculturist  should 
stay  on  the  farm :  that  the  nation  may  profit  by  the  con- 
tinued labor  of  a  food  producer  which  it  cannot  afford 
to  lose.  In  France  there  has  been  a  country-wide 
propaganda  to  this  end,  and  posters  and  booklets  have 
set  forth  the  exhortation:  '^Agriculteurs,  ne  changez  pas 
de  metier.''  The  movement  from  the  farm  to  the  fac- 
tory is  already  too  pronounced,  and  in  the  European 
countries  the  farm  workers  have  seen  it  was  they  that 
were  sent  first  to  the  trenches,  while  many  of  the  indus- 
trial employees  were  kept  at  home  in  the  munition  plants. 
Determined  efforts  have  been  made  to  counteract  the 
trend,  and  great  ingenuity  has  been  addressed  to  the 
solution  of  difficulties  in  the  path  of  the  disabled  farmer. 


THE      NEW      SCHOOLHOUSE  61 

There  still  remains  to  be  considered  the  man  without 
real  occupational  experience.  A  soldier  of  one  type  may 
have  held  in  the  two  years  prior  to  his  enlistment  ten 
different  jobs — all  makeshift  in  character  and  all  ill  paid. 
He  may  have  left  school  at  fourteen  and  been  under  the 
necessity  of  going  to  work  to  help  support  the  family. 
In  such  an  instance  he  would  never  have  had  a  chance 
at  a  skilled  trade.  Now  that  he  has  gone  abroad  and 
been  injured  in  his  country's  service,  is  this  man  to  be 
denied  the  chance  he  missed  earlier  in  life?  It  should 
be  the  pride  of  the  community  to  give  it  to  him. 

Representative  of  another  type  is  the  young  man  who 
may  have  gone  into  the  army  direct  from  high  school. 
In  the  American  forces,  so  largely  made  up  of  youngsters, 
cases  of  this  kind  will  be  numerous.  When  this  youth 
graduates  from  military  service,  a  disabled  veteran,  he 
should  be  provided  with  the  same  vocational  advantages 
as  he  might  have  availed  himself  of  had  not  the  war 
rudely  interrupted  his  educational  career. 

With  both  these  types  there  is  no  past  experience  to 
serve  as  an  occupational  determinant  for  the  future. 
Choice  is  therefore  free,  and  the  usual  principles  of  voca- 
tional guidance  will  apply. 

For  the  man  with  superior  mental  qualifications  little 
assistance  in  readaptation  is  necessary.  He  will  find  a 
way  to  keep  on  with  his  work.  Professional  men  can, 
in  spite  of  even  serious  handicaps,  continue  in  their  own 
line.  Disability  does  not  mean  as  much  to  the  head 
worker — architect,  chemist,  statistician,  or  designer,  as 
it  does  to  the  manual  worker — machinist,  textile  worker, 
stone  mason,  or  shoemaker. 

Most  of  the  men  of  mental  qualifications  who  will 
profit  by  re-educational  provision  by  the  national  authori- 


62  THE      DISABLED      SOLDIER 

ties,  are  the  younger  soldiers  who  can  take  up  or  con- 
tinue courses  at  universities  or  professional  schools.  The 
range  of  training  should  not  be  limited  to  the  trades; 
the  educational  opportunity  should  only  be  conditioned 
by  the  talents  and  possibilities  of  the  pupil.  In  Canada 
numbers  of  men  have  been  sent  to  college  with  their 
living  expenses  and  tuition  paid  by  the  government, 
and  the  same  situation  will  doubtless  ensue  here  to  as 
great  if  not  a  greater  degree. 

And  finally,  there  is  the  man  without  enough  mentality 
to  make  possible  his  training  in  a  skilled  trade.  After 
it  is  clear  that  nothing  can  be  done  for  him  vocationally, 
he  may,  as  a  last  resource,  be  equipped  with  as  effective 
mechanical  aids  as  possible  to  offset  the  handicap  of  his 
disability,  and  returned  to  manual  labor.  If  foreign- 
speaking  his  chances  may  be  improved  by  teaching  him 
to  speak  English.  Luckily,  however,  cases  of  this  char- 
acter will  be  few  among  men  of  our  own  forces,  by  reason 
of  the  high  standards  of  admission  to  and  retention  in 
the  army.  A  densely  stupid  man  would  never  get  as 
far  as  the  front  line  overseas. 

The  courses  of  training  must  be  intensive  and  practical 
rather  than  theoretical.  Every  feature  of  instruction 
must  be  evaluated  according  to  whether  it  affords  direct 
assistance  to  the  man's  earning  a  living.  A  mistake  that 
has  often  been  made  especially  by  universities  and  other 
institutions  of  higher  learning  is  to  give  the  disabled 
soldiers  the  elementary  first-year  schedule  of  a  regular 
four-year  course.  This  gives  them  a  little  of  everything 
and  complete  familiarity  with  almost  nothing.  What 
must  rather  be  done  is  to  pick  the  essential  and  practical 
features  out  of  the  whole  four-year  program  and  condense 
them  into  the  compass  of  a  short  course. 


A  Cheerful  Pupil.     French  soldiers  at  the  &cole  Joffre, 
Lyons,  learn  to  operate  machines 


THE      NEW      SCHOOLHOUSE  63 

In  place  of  grinding  for  a  final  examination  upon  which 
academic  rating  may  be  established,  it  is  better  to  devote 
the  last  one  or  two  months  of  training  to  practical  work 
in  the  field  for  which  the  training  prepares.  When  the 
students'  association  at  Calgary,  Canada — made  up  of 
the  returned  soldiers  being  trained  at  the  Institute  of 
Technology  and  Art — were  asked  for  suggestions  re- 
garding how  the  instruction  might  be  improved,  they 
answered  that  their  chief  concern  was  that  they  should 
know  when  they  went  out  to  a  job  just  what  was  expected 
of  them.  The  apprehension  was  that  they  might  be 
made  ridiculous  and  show  up  as  inexperienced  in  com- 
parison with  other  workmen  who  might  be  hired  for  the 
position.  To  eliminate  this  possibility  the  men  are  put, 
before  graduation,  at  actual  work  of  the  same  character 
as  will  be  required  by  their  first  employer.  For  example, 
the  men  training  as  operators  of  gasoline  tractors  are 
set  to  plowing  virgin  prairie  and  doing  other  miscellan- 
eous farm  work,  all  under  helpful  supervision  by  their 
instructors.  They  go  out,  therefore,  not  as  novices  but 
as  full-fledged  workers. 

In  like  manner,  at  Winnipeg,  Canada,  the  men  who 
have  been  trained  for  clerical  positions  are  put  for  the 
last  month  of  the  course  in  a  model  office,  equipped  with 
all  the  modern  appliances  such  as  adding  machines, 
billing  machines,  filing  systems  of  all  kinds,  telephone 
switchboard,  and  the  like.  Such  equipment  does  not 
embarrass  them,  therefore,  when  they  go  to  their  real 
work. 

It  has  already  been  pointed  out  that  courses  must  not 
be  too  long,  and  that  this  necessity  serves  to  exclude 
some  subjects  from  choice  for  the  training  of  disabled 
soldiers.    Nine  months  is  as  long  as  the  average  course 


64  THE      DISABLED      SOLDIER 

can  wisely  take,  and  one  year  is  usually  the  limit.  The 
Canadian  authorities  endeavor  to  make  most  of  the 
courses  come  within  six  months.  Many  subjects  can 
satisfactorily  be  taught  in  an  even  shorter  time,  for 
example,  power  station  switchboard  operating,  oxy- 
acetylene  welding,  and  so  forth. 

A  question  closely  related  to  the  manner  of  teaching 
is  that  of  character,  source,  and  training  of  instructional 
officers.  Whether  they  shall  be  drawn  from  the  ranks 
of  teachers  or  from  among  engineers  or  manufacturers 
is  a  subject  of  wide  discussion.  The  tendency  in  Canada 
now  is  to  depend  on  the  latter  source,  the  argument 
being  that  the  problem  is  industrial  rather  than  educa- 
tional, and  a  material  proportion  of  the  training  is  being 
done  in  shops.  In  Great  Britain  the  solution  is  clear, 
since  most  of  the  work  is  done  in  already  existing  and 
organized  technical  institutes,  whose  regular  staffs  carry 
on  the  teaching.  In  the  United  States  the  first  workers 
are  being  drawn  from  the  vocational  education  field, 
some  of  the  men  having  been  given  a  special  course  of 
study  in  New  York  and  travel  and  observation  in  Canada, 
in  order  that  they  may  know  how  to  apply  their  own 
particular  technical  experience  to  work  with  the  disabled 
soldier.  If  such  men  serve  as  directors  or  vocational 
advisers,  it  is  fairly  simple  to  draw  the  actual  instructors 
from  trade  workers  and  imbue  them  with  the  right 
social  spirit  in  dealing  with  the  men.  It  needs  teachers 
of  manifest  experience  and  competence  to  command  the 
respect  of  the  disabled  soldiers. 

It  becomes  of  increasing  importance  as  the  war  pro- 
gresses to  recruit  as  directors  and  teachers  returned 
soldiers  who  have  seen  service  at  the  front.  They  get 
better  work  from  their  pupils  and  are  in  an  infinitely 


THE      NEW      SCHOOLHOUSE  65 

better  position  to  maintain  discipline.  The  man  wounded 
overseas  tends  quite  naturally  to  regard  stay-at-home 
citizens  as  slackers,  and  he  demands  employment  of 
veteran  comrades  in  their  stead. 

It  has  required  some  courage  in  Canada  to  stand  out 
against  the  demand  for  appointment  to  a  job  of  a  re- 
turned soldier  of  inferior  qualifications  rather  than  a 
civilian  of  marked  ability.  Now,  however,  the  great 
majority  of  representatives  of  the  Invalided  Soldiers' 
Commission  have  seen  overseas  service.  In  the  repatria- 
tion service  of  Australia  the  minister  recently  reported 
that  ninety  per  cent,  of  the  men  on  the  payroll  were 
returned  soldiers.  Immediately  the  voices  of  parlia- 
mentary members  were  heard  in  criticism  that  the  pro- 
portion should  have  been  still  higher. 

If  the  military  officers  are  used  in  any  relation  to  re- 
education, it  is  practically  essential  that  they  be  officers 
themselves  invalided  from  the  front.  The  soldiers 
regard  the  uniform  as  the  badge  of  a  fighting  man,  do 
not  look  kindly  on  its  assumption  by  stay-at-homes,  and 
practically  refuse  to  acknowledge  the  authority  of  an 
officer  who  has  not  seen  actual  service.  Of  course,  this 
necessity  does  not  become  operative  until  some  little 
time  after  belligerency  begins. 

In  setting  out  to  provide  for  the  re-education  of  dis- 
abled soldiers  what  facilities  should  be  employed?  Can 
existing  facilities  be  utilized  or  must  special  schools  be 
erected  or  organized? 

The  ideal  arrangement  would  be  to  assign  men  for 
training — under  national  supervision  and  at  national 
expense — to  a  special  vocational  school  for  the  disabled, 
but  these  practically  do  not  exist.  The  reason  why  this 
would  be  desirable  is  that  the  staff  would  be  already 


66  THE      DISABLED      SOLDIER 

familiar  with  the  particular  difficulties  of  the  disabled 
man,  and  experienced  in  dealing  with  him.  The  re- 
habilitation of  the  physically  handicapped  is  not  wholly 
an  educational  or  industrial  problem — it  is  very  largely 
a  social  one. 

The  men  who  might  be  highly  successful  in  the  voca- 
tional education  of  young  men  might  fail  of  the  patience 
requisite  to  the  training  of  the  disabled.  Due  perhaps  to 
the  past  public  attitude  toward  the  crippled  and  blind, 
perhaps  to  expectation  of  future  support  by  pension  or 
compensation,  perhaps  to  a  feeling  of  helplessness  on  the 
part  of  the  man  for  going  out  again  into  industry,  there  is 
certainly  a  psychology  of  disability  and  as  surely  a  social 
philosophy  for  meeting  it.  Although  preparation  of  teach- 
ers and  directors  by  theoretical  instruction  and  observa- 
tion may  accomplish  much,  real  capability  is  attained 
only  by  actual  experience  with  the  disabled  man  himself. 
This  experience  the  special  school  for  the  handicapped, 
if  operated  on  modern  lines,  brings  ready  to  the  task. 
But  although  every  industrial  community  needs  such 
schools,  they  do  not  exist.  Dependence  for  the  execution 
of  an  extensive  national  program  must  in  consequence 
be  placed  on  other  means. 

The  most  useful  facilities  to  hand  are  the  existing 
vocational  schools.  These  institutions  have  equipment 
and  teachers  and  can  undertake  on  short  notice  the 
training  of  disabled  soldiers.  It  has  been  found  neces- 
sary, however,  to  organize  special  classes  for  the  soldiers 
rather  than  put  them  in  the  same  classes  as  the  boys 
under  instruction.  The  men  are  mortified  at  the  dis- 
crepancy in  ages  and  being  some  time  away  from  their 
school  days  are  not  as  quick  to  catch  on  at  first  to  class- 
room instruction.    The  necessity  for  special  classes  has 


THE      NEW      SCHOOLHOUSE 67 

been  clearly  demonstrated  in  Great  Britain  where  the 
already  operating  technical  institutes  have  been  largely 
availed  of. 

The  utilization  of  these  facilities  is  highly  logical  as 
it  would  be  folly  to  purchase  and  install  special  mechani- 
cal equipment  for  the  temporary  need  involved  in  the 
rehabilitation  of  wounded  soldiers.  The  only  justifica- 
tion for  organizing  a  special  school  for  the  disabled  is  a 
permanent  program  for  the  rehabilitation  of  the  handi- 
capped— civilian  as  well  as  military.  In  such  instances, 
the  separate  institution  is  not  only  permissible  but 
desirable. 

The  vocational  schools  have  been  very  ready  to  come 
forward  with  offers  of  their  facilities.  In  Great  Britain 
most  of  the  great  technical  institutes  have  organized 
special  classes  in  general  trade  subjects  for  the  returned 
soldier;  for  example,  the  Regent  Street  Polytechnic  and 
the  Northampton  Polytechnic  in  London,  the  Technical 
Institute,  Birmingham,  and  the  Newport  Technical  In- 
stitute in  South  Wales.  The  courses  at  these  schools  are 
approved  by  the  Ministry  of  Pensions  which  also  pays 
tuition  of  the  men. 

Schools  for  teaching  individual  trades  have  also  pro- 
vided facilities  for  the  war  cripple.  Examples  of  this  are 
the  school  of  diamond  cutting  at  Saint-Claude,  celluloid 
industry  at  Oyonnax,  cutlery  at  Thiers,  and  watch- 
making at  Cluses,  France;  tool-making  at  the  Metal- 
crafts  Training  Institute,  boot  repairing  and  leather  work 
at  the  Cordwainers'  Technical  College  in  London. 

Another  type  of  vocational  school  is  represented 
by  the  business  college  or  clerical  school.  These  can 
organize  special  classes  and  enlist  a  fair  number  of 
pupils.     Clerical  instruction  is  provided  in  most  of  the 


68  THE      DISABLED      SOLDIER 

military  hospitals,  and  some  of  the  men  taking  this 
work  reveal  talents  and  aptitudes  which  lead  to  their 
taking  up  a  clerical  specialty  as  their  re-educational 
subject. 

Still  another  vocational  branch  is  agricultural  training, 
which  can  be  excellently  provided  by  existing  agricul- 
tural colleges.  In  France  the  national  schools  have 
made  provision  for  the  poilu  put  out  of  commission  at 
the  front;  in  Canada  provincial  schools  of  agriculture 
have  undertaken  the  work ;  in  New  Zealand  the  Depart- 
ment of  Agriculture  is  caring  for  the  farm  training  of 
returned  soldiers. 

Still  another  class  of  educational  organization  which 
can  be  utilized  to  advantage  is  the  university.  While 
the  vocational  school  for  boys  may  have  its  full  quota 
of  pupils,  the  university  in  war  time  is  denuded  of  stu- 
dents. And  most  universities  today  have  engineering 
or  agricultural  departments  which,  otherwise  idle,  can 
be  made  useful  indeed.  McGill  University  in  Montreal 
is  training  under  supervision  and  at  the  expense  of  the 
Invalided  Soldiers'  Commission  a  large  number  of 
returned  men.  The  University  of  Saskatchewan  at 
Saskatoon  is  preparing  many  for  agriculture.  In  the 
other  Canadian  provinces  the  University  of  Toronto  and 
the  University  of  British  Columbia  are  contributing 
splendidly  to  the  national  program. 

In  conjunction  with  every  military  hospital  giving 
reconstruction  or  long-time  treatment  some  educational 
provision  is  necessary.  Of  course,  this  may  consist  only 
in  teaching  ward  occupations  and  simple  pre-vocational 
work.  But  in  many  cases  it  has  been  found  wise  to  start 
vocational  training  during  the  hospital  period.  In  con- 
nection with  every  "center  of  physiotherapy"  in  France  is 


THE      NEW      SCHOOLHOUSE  69 

a  re-educational  school.  In  England,  at  the  Brighton  and 
Roehampton  orthopedic  and  limb-fitting  hospitals,  have 
been  organized  schools  in  which  the  men  start  their 
vocational  training,  which  is  continued,  after  hospital 
care  is  finished,  as  a  post-graduate  course  at  one  of  the 
London  polytechnics. 

During  the  early  stages  of  the  work  in  Canada,  it  was 
the  practice  to  begin  re-education  while  the  men  were 
still  under  medical  care.  Under  new  administration,  on 
the  showing  of  experience,  a  new  ruling  was  made  about 
the  middle  of  1918.  This  provided  that  no  more  men 
were  to  start  industrial  training  until  after  discharge, 
and  not  then  until  after  medical  treatment  was  finished. 
Up  to  this  point  all  occupation  has  a  therapeutic  objective 
and  is  carried  on  in  curative  workshops. 

In  cities  and  districts  where  there  are  for  one  reason 
or  another  no  vocational  education  facilities  which  can 
be  turned  to  the  training  of  disabled  soldiers,  there  be- 
comes necessary  the  establishment  of  a  special  school  of 
re-education  to  meet  the  need.  There  have  been  founded 
in  this  way  a  number  of  institutions  which  it  is  hoped 
will  continue  to  train  disabled  industrial  workers  after 
the  temporary  need  for  the  rehabilitation  of  soldier 
cripples  has  passed. 

The  leading  examples  of  this  type  of  school  are  at 
Lyons,  France,  and  Diisseldorf,  Germany.  The  former 
has  been  already  described.  The  latter  serves  the  men 
under  treatment  at  fifty  hospitals  in  the  city  of  Diissel- 
dorf or  resident  there  after  military  discharge. 

In  analyzing  the  past  experience  and  employment  pos- 
sibilities of  an  individual  disabled  man,  the  need  for  an 
extremely  large  number  of  instruction  subjects  is  indi- 
cated.   A  recent  listing  of  the  subjects  being  taught  to 


70  THE      DISABLED      SOLDIER 

returned  soldiers  in  Canada  showed  a  total  of  two  hun- 
dred. When  we  proceed  on  the  assumption  that  the 
individual  is  to  receive  training  in  the  line  for  which  he 
is  best  fitted,  the  variety  of  classes  called  for  is  beyond 
the  range  of  any  vocational  school  to  provide.  The 
question  is  then:  How  is  instruction  in  the  unusual 
subjects  to  be  provided? 

This  necessity  has  given  rise  to  the  re-establishment 
of  the  apprentice  system.  More  and  more  dependence 
is  coming  to  be  placed  on  training  in  factories  and  indus- 
trial establishments.  Under  this  system  the  tange  of 
subjects  is  almost  unlimited. 

The  employer  must  be  willing  to  undertake  very  def- 
initely the  instruction  of  the  soldiers,  and  detail  one  or 
more  of  his  best  men  to  this  end.  There  must  be  regular 
supervision  of  the  work  and  inspection  of  the  progress 
made  by  the  apprentice  in  order  to  guard  against  the 
employer  using  the  men  for  routine  production  processes 
with  little  or  no  progress  or  educational  value.  He  must 
not  be  allowed  to  regard  their  time  as  possible  labor 
obtained  free  or  at  small  cost. 

On  the  other  hand,  properly  regarded,  the  system 
confers  real  benefits  on  the  employer.  In  the  first  place 
it  affords  him  a  source  of  supply  for  skilled  labor  which 
may  be  very  scarce  and  difificult  to  obtain;  for  most  of 
the  men  trained  in  a  factory  stay  on  in  the  same  place 
as  employees  after  their  instruction  period  is  over. 
Being  familiar  with  the  shop's  practice  they  are  worth 
more  to  it  than  to  anotherestablishment  and,  conversely, 
being  more  valuable  as  workers  the  employer  can  afford 
to  pay  them  more  wages  than  they  could  ordinarily  earn 
elsewhere.  In  the  second  place,  the  employer  can  train 
the  men  in  his  own  methods  and  to  his  own  standards, 


THE      NEW      SCHOOLHOUSE  71 

and  prepare  workmen  made  as  it  were  to  order.  For 
these  two  advantages  employers  are  frequently  willing 
to  operate  apprentice  schools  and  pay  the  pupils  wages 
during  their  non-productive  period. 

In  Great  Britain  no  fees  are  paid  to  the  employer  for 
such  training,  and  he  is  expected  to  pay  the  disabled 
men  wages  which  will  represent  the  net  value — if  any — 
of  the  men's  labor  in  his  establishment.  The  wages  thus 
paid  are  deducted  from  the  training  allowance  paid  by 
the  Ministry  of  Pensions.  In  Canada,  in  view  of  the 
very  generous  scale  of  pay  and  allowances,  it  is  thought 
best  that  the  man  should  not  be  paid  wages.  If  the 
employer  gives  him  anything,  it  is  regarded  in  the  light 
of  a  bonus  and  does  not  prejudice  his  remittances  from 
the  government. 

A  modification  of  the  system  of  training  men  by  place- 
ment in  factories  consists  in  starting  the  course  of  re- 
education in  a  vocational  school  and  completing  it  in 
an  industrial  establishment.  Subjects  of  training  fall 
within  classifications  as  to  elementary  preparation,  and 
most  of  them  are  represented  to  some  degree  in  the  indus- 
trial schools.  For  example,  a  man  who  requires  training 
as  a  silver-plater  may  learn  the  general  principles  of  elec- 
tricity in  a  school  classroom  and  laboratory  and  then 
go  out  to  a  plating  shop  for  training  in  the  application 
of  these  principles  in  plating  practice. 

It  is  this  combination  of  school  and  factory  training 
which  promises  the  widest  development  in  the  future. 

One  great  advantage  of  having  part  or  all  of  the  train- 
ing done  in  a  factory  is  that  the  work  is  practical  in  the 
highest  degree,  taking  place  as  it  does  under  actual  pro- 
duction conditions.  All  that  is  purely  theoretical  or 
extraneous  is  eliminated. 


72  THE      DISABLED      SOLDIER 

This  training  on  the  apprentice  system  has  reached 
its  highest  development  in  Canada,  where  the  executive 
officer  of  the  vocational  work  has  been  enthusiastic 
regarding  its  merits  and  has  secured  exceptionally  suc- 
cessful results.  The  range  of  training  possibilities  is  well 
exemplified  by  some  selections  from  the  list  of  occupa- 
tions for  which  disabled  soldiers  of  the  Canadian  forces 
are  now  being  re-educated:  armature  winding,  harness 
fitting,  tinsmithing,  saxophone  playing,  pneumatic  tool 
repairing,  inspection  of  castings,  watch-making,  fur  work, 
dental  mechanics,  storage  battery  repairing,  tailoring, 
telegraphy,  meat  cutting,  bronze  finishing,  linotype  or 
monotype  operation,  piano  tuning,  milling  and  assaying, 
bronze  finishing,  lense  grinding,  ornamental  ironwork, 
precious  stone  cutting,  lead  glazing,  photography,  and 
so  forth. 

A  typical  school  of  re-education  is  the  National  Insti- 
tute for  War  Invalids,  at  Saint-Maurice,  near  Paris.  This 
is  a  combination  of  an  orthopedic  hospital  and  a  training 
center.  It  is  under  the  joint  control  of  the  Ministries  of 
War  and  of  the  Interior,  the  former  administering  the 
medical  activities,  and  the  latter  the  re-educational  work. 

The  soldier  remains  under  charge  of  the  War  Depart- 
ment until  medical  treatment  is  completed,  and  the 
necessary  prosthetic  apparatus  provided.  He  is  then 
discharged  from  the  army  and  passes  under  the  jurisdic- 
tion of  the  Ministry  of  the  Interior. 

The  military  hospital,  containing  seven  hundred  beds, 
is  equipped  for  all  kinds  of  medical  and  surgical  work. 

The  prosthetic  division  consists  of  five  shops.  In  one 
is  tested  the  apparatus  supplied  by  private  concerns ;  in 
the  other  four,  orthopedic  appliances  and  prostheses  are 


THE      NEW      SCHOOLHOUSE 73 

manufactured  by  workers  whose  services  have  been 
commandeered  by  the  Ministry  of  War. 

The  hospital  and  the  school  operate  conjointly.  In 
many  instances  the  trade  training  begins  while  the 
patient  is  still  undergoing  treatment. 

The  trades  taught  at  the  Institute  are  shoemaking, 
tailoring,  tinsmithing,  and  harness-making.  There  is  also 
a  commercial  section,  which  includes  courses  in  primary 
instruction,  in  commercial  bookkeeping,  and  drafting. 
Finally,  there  is  a  special  department  where  the  men  are 
taught  to  operate  and  repair  tractors,  agricultural  ma- 
chinery, and  automobiles. 

The  men  are  lodged  and  boarded  at  the  Institute. 
The  dormitories  can  accommodate  three  hundred  pupils ; 
in  addition,  seventy-five  beds  in  the  hospital  are  reserved 
for  men  under  training  in  the  workshops. 

One-armed  men  are  not,  as  a  general  rule,  directed 
into  industrial  pursuits.  In  exceptional  cases,  however, 
former  agricultural  workers  are  taught  tractor  operation. 
Whenever  suitable,  men  with  arm  injuries  or  amputa- 
tions are  given  instruction  in  drafting  or  in  commercial 
subjects. 

One  of  the  principles  of  the  school  is  to  make  the  period 
of  apprenticeship  as  short  as  possible.  Dr.  Bourrillon 
estimates  that  the  time  rejquired  to  give  an  adequate 
training  is  four  months  for  a  bookkeeper,  six  months 
for  a  tinsmith,  eight  months  for  a  shoemaker  or  agricul- 
tural mechanic,  ten  months  for  a  harness-maker,  and  a 
year  for  primary  instruction  of  an  illiterate  or  for  indus- 
trial design. 

The  most  popular  workroom  in  the  school  is  the  shoe- 
making  shop,  the  number  of  pupils  averaging  sixty.  Most 
of  the  men  attending  this  course  are  one-legged  or  legless. 


74  THE      DISABLED      SOLDIER 

Half  of  them  are  farmers  who  intend  to  return  to  their 
homes.  A  month's  training  is  allowed  for  plain  machine 
stitching,  seaming  welting,  and  soling.  At  the  end  of 
five  months,  the  men  should  be  able  to  re-sole  shoes, 
both  pegged  and  hand-sewed.  Complete  shoes  are  made 
by  men  of  average  ability  after  eight  months. 

The  tailoring  department  was  not  successful.  The 
minimum  apprenticeship  of  one  year  the  men  considered 
too  long,  and  there  were  but  few  willing  to  undertake  it. 
Instruction  in  this  trade  was  therefore  discontinued. 

In  the  harness-making  shop,  all  branches  of  the  trade 
are  taught,  though  the  greater  part  of  the  business  is 
repair  work.  As  by-products,  the  shop  turns  out  small 
leather  articles,  such  as  pocketbooks  and  cigarette  cases. 

The  metal  work  shop  turns  ou,t  fireless  cookers,  army 
canteens,  and  small  tin  articles.  The  men  are  taught 
sufficient  of  pattern  work,  soldering,  and  joining  to 
become  journeymen  in  the  trade. 

The  department  of  farm  mechanics,  which  include 
tractor  operating  and  repairing,  is  considered  as  one  of 
the  most  important,  in  view  of  the  great  demand  for 
agricultural  machinery  expected  after  the  war  on  account 
of  the  shortage  of  labor.  A  number  of  graduates  have 
been  placed,  either  on  farms  or  as  demonstrators  with 
firms  which  sell  agricultural  equipment. 

The  drafting  department  comprises  two  sections,  me- 
chanical and  architectural.  Arm  injuries  predominate 
in  this  department;  many  of  the  students  are  one- 
armed.  There  is  great  variety  in  the  former  occupations 
of  the  men;  alongside  of  five  draftsmen  who  had  lost 
their  right  arm  and  were  learning  to  do  left-handed 
work  were  found  nine  machinists,  one  butcher,  one  chair- 
maker,  one  sausage-maker,  one  cook,   three  peasants, 


THE      NEW      SCHOOLHOUSE  75 

three  cabinet-makers,  two  commercial  clerks,  one  en- 
graver, five  masons,  one  seaman,  two  joiners,  one  meter 
inspector,  two  electricians,  one  moulder,  one  building 
worker,  one  house  painter,  one  sculptor,  three  locksmiths, 
one  stone-cutter,  and  one  without  trade. 

The  course  in  accounting  shares  popularity  with  shoe- 
making.  The  number  of  applications  for  this  course  is 
so  large  that  it  has  been  found  necessary  to  confine  ad- 
mission to  men  injured  in  the  arm  and  men  formerly 
employed  in  commerce;  the  latter  make  thirty-six  per 
cent,  of  the  pupils.  Among  the  others  are  found  a  con- 
siderable number  of  former  pea^nts — about  twenty 
per  cent. — and  miners,  masons,  lathe-workers,  printers, 
basket-makers,  laundry  hands,  and  so  on. 

The  pupils  are  free  in  choosing  their  trade;  they  are 
free  also  to  change  to  another  trade  if  the  first  choice 
has  proved  unsatisfactory.  They  may  also  leave  school 
at  any  time  they  desire.  Discipline  has  been  reduced  to 
the  minimum,  and  every  unnecessary  limitation  upon 
the  freedom  of  the  pupils  has  been  eliminated. 

The  administration  makes  it  clear,  however,  that  the 
Institute  is  a  place  for  work  and  study  rather  than  an 
asylum  home;  it  reserves  the  right  to  dismiss  any  man 
who  does  not  work  with  sufficient  industry  to  learn  a 
trade  in  a  reasonable  time. 

So  long  as  the  product  of  his  labor  cannot  be  disposed 
of,  each  pupil  receives  a  wage  of  fifty  centimes  a  day. 
When  the  product  is  sold,  the  man  receives  his  part  of 
the  profit  realized,  one-half  being  paid  to  him  in  cash 
fortnightly  and  the  balance  deposited  to  his  credit  until 
discharge,  when  he  receives  his  accumulated  savings 
and  sometimes,  in  addition,  a  grant  in  cash  or  a  set  of 
tools. 


76  THE      DISABLED      SOLDIER 

During  the  first  two  years  of  the  operation  of  the 
Institute,  the  number  of  pupils  admitted  was  923,  and 
the  number  of  graduates  481.  Of  these,  398  were  placed 
in  employment  by  the  Institute. 

In  addition  to  the  men  who  are  trained  at  the  Institute, 
others  are  assigned  to  various  re-educational  schools  in 
Paris,  or  are  placed  as  apprentices  in  private  shops.  In 
both  cases,  the  training  is  supervised  by  the  Institute. 

The  Institute  maintains  a  boarding  annex  in  Paris 
for  the  pupils  who  are  trained  outside.  If  during  the 
training  the  man  receives  sufficient  wages,  he  may  be 
required  to  pay  one  franc  seventy  centimes  a  day  for 
his  board.  The.  man  is  not  maintained  at  the  annex  if 
his  earnings  exceed  four  francs  a  day. 

By  taking  advantage  of  the  facilities  of  outside  schools 
and  workshops,  the  Institute  is  enabled  to  provide 
for  the  men  instruction  in  any  trade.  Experience  has 
shown,  however,  that  the  best  results  are  obtained  when 
the  men,  while  receiving  training,  are  under  direct  super- 
vision of  the  administration  of  the  Institute  and  not 
exposed  to  the  varied  temptations  and  distractions  of 
the  capital  city. 

In  Germany,  one  of  the  most  important  institutions  is 
the  Diisseldorf  School  for  the  wounded.  It  was  created 
by  the  so-called  Headquarters  for  Voluntary  Relief,  an 
organization  which  had  been  formed  for  war  relief  in 
general,  by  amalgamating  the  interests  of  the  local  Red 
Cross,  the  Women's  Patriotic  League,  and  the  city 
administration. 

The  first  step  in  re-educational  work  was  the  creation 
of  a  department  of  vocational  advice  for  wounded  soldiers 
under  treatment  in  the  fifty  military  hospitals  of  the  city, 
which  is  a  hospital  center  for  the  Rhine  province.    The 


THE      NEW      SCHOOLHQUSE 77 

vocational  advisers  come  in  touch  with  the  wounded  man 
at  the  early  stage  of  convalescence,  when  there  is  greatest 
danger  of  the  onset  of  mental  lethargy. 

In  February,  1915,  about  twenty  general  educational 
courses  were  started  in  one  of  the  city's  school  buildings. 
Later,  new  and  more  suitable  buildings  were  erected  and 
equipped  with  machinery  and  tools.  Technical  courses 
training  for  many  trades  were  instituted,  and  provision 
made  for  the  maintenance  of  the  pupils  and  for  allow- 
ances to  their  families. 

The  various  courses  prepare  men  for  employment  as 
metal  workers,  engineers,  telegraphers,  electricians,  car- 
penters, cabinet-makers  and  wood-workers,  workers  in 
the  building  trades,  locksmiths,  sculptors,  stone-cutters, 
paper-hangers  and  plasterers,  printers,  photographers 
and  etchers,  bookbinders,  cardboard  and  leather  workers, 
dental  mechanics,  farmers,  civil  service  employees,  sten- 
ographers, and  office  workers.  The  trade  courses  prepare 
for  the  master-workers'  examinations  which  can  be  taken 
at  the  Diisseldorf  Board  of  Trade.  Time  spent  at  the 
school  counts  as  time  spent  as  a  journeyman's  apprentice. 
Examination  fees  have  been  waived  for  disabled  soldiers. 
Also,  instead  of  offering  a  pretentious  sample  of  work  as 
a  "masterpiece,"  the  would-be  master  worker  simply  has 
to  prove  that  he  can  do  what  is  required  of  a  first-class 
workman  in  the  particular  trade.  The  Board  of  Trade 
has  provided  for  a  special  tradeworkers'  course  in  pre- 
paration for  the  examinations. 

As  a  general  rule,  it  is  aimed  to  restore  every  man  to 
his  former  occupation.  When  physical  disability  pre- 
cludes this  program,  the  object  is  to  prepare  him  for 
some  other  position  in  the  same  line,  usually  for  one  that 
requires  less  physical  but  more  intellectual  effort.    The 


78  THE      DISABLED      SOLDIER 

program  of  instruction  includes,  therefore,  in  addition  to 
the  practical  trade  courses  and  shop  work,  ample  provi- 
sion for  theoretical  training. 

The  courses  preparing  for  office  positions  are  the 
most  popular  with  the  disabled  men,  in  Diisseldorf  as 
elsewhere.  An  effort  is  made,  however,  to  keep  trade 
workers  from  turning  to  oflfice  work.  The  tendency  is 
to  reserve  the  clerical  courses  for  men  who  formerly  held 
minor  government  positions  and  who  wish  to  prepare  for 
civil  service  examinations,  or  for  those  who  are  too 
severely  injured  to  perform  physical  labor,  and  especially 
for  former  traveling  salesmen  and  sales  clerks  who  by 
reason  of  their  injuries  must  seek  office  jobs,  preferably 
in  their  old  line  of  business. 

Finally  there  is  the  department  of  general  education, 
which  teaches  civics,  rhetoric  and  grammar,  and  simple 
manual  training,  preparatory  to  more  intensive  voca- 
tional work  later  to  be  undertaken.  There  is  also  pro- 
vision for  training  the  left  hand  of  men  who  have  lost 
their  right  hand  or  arm,  and  it  has  been  found  that  a 
five  weeks*  course  is  sufficient  to  give  these  men  a  free 
and  characteristic  handwriting.  In  this  work  the  one- 
armed  pupils  are  taught  by  similarly  handicapped 
instructors. 

In  the  Diisseldorf  school  sports  and  games  play  a  r61e 
of  considerable  importance — not  only  recreational  but 
curative  as  well.  By  three  months  of  swimming  practice 
one  of  the  pupils  recovered  the  entire  use  of  a  paralyzed 
forearm. 

When  training  is  completed,  the  soldier  is  ready  for 
useful  and  remunerative  employment — to  realize  upon 
the  values  created  during  re-education. 


ATWORKAGAIN  79 


CHAPTER  VI 

AT  WORK  AGAIN 

The  real  measure  of  success  in  putting  the  disabled  man 
back  on  his  feet  is  his  showing  on  entry  into  regular 
employment.  In  matter  of  fact,  the  training  is  really 
the  preliminary  part  of  the  placement  program,  inasmuch 
as  the  original  choice  of  subject  was  made  with  reference 
to  a  definite  labor  demand,  and  the  instruction  largely 
determined  by  the  employment  requirements  of  the  job 
in  prospect. 

The  finding  of  jobs  for  men  trained  in  skilled  trades  is 
a  comparatively  simple  matter,  and  it  will  be  found  that 
the  good  trade  school  usually  has  its  pupils  placed  before 
their  course  is  completed.  So  with  the  schools  of  re- 
education, the  men  are  often  taken  away  prior  to  gradu- 
ation. The  heads  of  such  schools  are  closely  in  touch 
with  industry  and,  in  a  very  informal  way,  keep  on  the 
lookout  for  good  openings  for  their  pupils. 

The  men  trained  wholly  or  partly  in  factories  are 
usually  kept  on  by  the  employer  with  whom  they  are 
placed.    There  is  thus  no  necessity  of  finding  them  a  job. 

As  has  been  pointed  out,  not  all  disabled  men  are  dis- 
qualified from  return  to  their  former  jobs,  and  thus  many 
do  not  become  candidates  for  re-education.  As  soon  as 
hospital  treatment  is  completed,  they  are  ready  to  return 
to  work.  In  the  majority  of  instances  they  go  back  to 
their  former  job.  On  a  questionnaire  filled  out  by  em- 
ployers in  one  of  the  Canadian  provinces  it  was  asked 
whether  former  employees  who  were  disabled  at  the 


80  THE      DISABLED      SOLDIER 

front  could  count  on  the  jobs  which  they  left  upon 
enlistment.  The  answers  were  emphatically  in  the 
affirmative:  "absolutely,"  or  "surest  thing  you  know," 
"you  bet,"  and  more  of  the  same  character.  The  patri- 
otic motive  in  this  case  can  safely  be  availed  of,  because 
the  best  placement  possible  is  to  return  a  man  to  an 
employer  who  knows  him  well,  and  to  a  job  with  which 
he  is  both  satisfied  and  familiar. 

In  Australia  one  of  the  first  moves  by  the  repatriation 
authorities  after  the  return  of  the  soldier  is  to  communi- 
cate with  his  last  employer,  stating  the  man's  disability 
and  asking  whether  his  old  position  is  open  for  him,  and 
in  the  event  that  he  is  disqualified  for  that  job,  whether 
there  is  another  into  which  he  can  be  fitted.  Enlistment 
in  the  Australian  Commonwealth  was  and  has  remained 
entirely  voluntary.  As  one  inducement  to  joining  the 
forces  many  employers  promised  to  hold  jobs  open  for 
men  until  their  return  from  the  front.  In  many  cases 
this  was  regarded  as  almost  a  contractual  obligation; 
the  man  went  to  France  or  Gallipoli  to  fight  for  interests 
in  which  his  employer  shared;  the  latter  agreed  that 
the  enlisted  man  should  not  lose  his  place  through 
following  the  course  of  duty.  So  keen  was  the  feeling 
regarding  this  reciprocal  responsibility  that  there  were 
even  discussions  in  Parliament  as  to  whether  employers 
should  be  required  by  law  to  make  good  their  promises. 
It  was  pointed  out,  quite  logically,  that  there  was  usually 
no  written  evidence  of  the  promise;  that  the  employer 
worth  working  for  would  live  up  to  his  word,  and  that 
in  the  case  of  any  other  the  man  would  profit  by  finding 
another  job.  The  authorities  have,  however,  secured  the 
cooperation  of  chambers  of  commerce  in  registering  offi- 
cially employers'  commitments  in  this  regard. 


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ATWORKAGAIN  81 

The  jobs  of  some  of  the  disabled  men  who  can  return 
to  their  former  occupation  will,  however,  have  disap- 
peared, due  to  suspension  of  operation,  business  failure, 
and  other  causes.  The  placement  in  these  instances  is 
comparatively  simple,  for  the  only  necessity  is  to  find 
the  man  a  similar  job. 

Still  other  men,  however,  who  remain  handicapped 
economically  have  not  had  or  do  not  take  advantage  of 
re-educational  opportunities.  For  such  every  resource  of 
skilled  employment  technique  is  called  into  play. 

One  of  the  most  difficult  tasks  in  the  placement  of 
disabled  soldiers  is  to  prevent  their  exploitation  by  em- 
ployers who  might  argue  that,  as  the  man  is  in  receipt 
of  a  regular  pension  from  the  government,  he  can  afford 
to  take  a  job  at  a  reduced  wage.  If  a  man  has  been  fitted 
competently  to  hold  down  a  given  position,  this  conten- 
tion is  indefensible,  and  is  contrary  to  the  whole  theory 
of  rehabilitation.  As  he  should  not  receive  wages  in 
excess  of  his  earning  power,  so  his  pay  must  not  be  prej- 
udiced because  he  has  some  outside  source  of  income. 
The  employer  must  not  be  permitted  to  regard  the  dis- 
abled man  as  a  source  of  labor  which  can  afford  to  work 
cheap. 

This  tendency  may  be  manifested  not  only  in  the 
original  wages  arrangement,  but  also  in  failure  to  in- 
crease wages  in  pace  with  augmented  skill  and  produc- 
tivity, the  employer  imagining  that  the  handicapped 
man  will  be  loath  to  leave  a  job  on  the  earnings  of  which 
— together  with  his  pension — he  can  comfortably  live. 
When  the  employment  authorities  are  satisfied  that  such 
a  situation  prevails,  the  man  should  be  immediately 
recalled  and  placed  in  another  job. 


82  THE      DISABLED      SOLDIER 

There  are  many  men,  however,  who  can  obtain  em- 
ployment in  the  regular  channels  of  industry  but  who, 
even  when  fully  paid  for  the  work  they  perform,  cannot 
earn  the  standard  wage.  In  order  to  assure  that  such 
men  are  not  overpaid  on  the  one  hand,  nor  exploited  on 
the  other,  there  have  been  set  up  in  several  countries, 
advisory  wages  boards,  which  assess  the  earning  capacity 
in  individual  cases.  These  boards  are  usually  composed 
of  an  equal  number  of  representatives  of  labor  and  capi- 
tal with  one  disinterested  party  to  act  as  chairman  and 
are  appointed  by  authority. 

This  question  is  regarded  as  of  the  greatest  importance, 
of  course,  in  the  countries  with  minimum  wage  laws,  and 
the  unions  have  been  solicitous  to  safeguard  any  invasion 
of  the  minimum  wage  protection  which  they  won  at  so 
great  pains.  In  New  Zealand  reduced  rate  permits  are 
issued  by  the  Returned  Soldiers'  Information  Depart- 
ment, allowing  a  man  to  accept  employment  at  less  than 
the  standard  wage.  In  Australia  the  unions  have  stipu- 
lated that  no  more  than  one  disabled  man  at  a  reduced 
wage  to  every  six  full-paid  journeymen  shall  be  employed 
in  any  given  establishment. 

The  trade  unionists  have  quite  properly  watched  the 
rehabilitation  activities  to  see  that  disabled  soldiers  were 
not  used  to  break  down  wage  standards  or,  half-trained 
in  some  of  the  skilled  trades,  utilized  as  strike-breakers. 
Both  apprehensions  had  some  foundation  in  fact  in  the 
inexperienced  and  blundering  days  when  the  work  first 
began.  In  one  city,  for  example,  a  large  class  of  motion 
picture  operators  was  trained  in  a  short  course  which 
did  not  adequately  prepare  them  for  the  occupation  they 
were  to  follow.  When  the  members  of  this  class  sought 
employment,  they  offered  to  work  for  less  wages  than  the 


ATWORKAGAIN  83 

regular  operatives,  and  succeeded  in  displacing  some  of 
the  latter  from  their  jobs.  This  caused  a  F^^nke,  and  all 
the  class  found  work  in  the  moving  picture  theatres. 
But  their  incumbency  was  short-lived,  for  short-circuits, 
fires,  and  other  accidents,  natural  to  inexperience,  decided 
the  strike  and  returned  the  old  operators  to  the  jobs. 
The  incident  showed  up  some  possibilities  which  boded 
ill  to  the  labor  men. 

Fortunately  the  rehabilitation  workers  have  seen  the 
danger  of  slipshod  training  and  exploitation  in  employ- 
ment and  have  done  everything  possible  to  guard  against 
them.  In  most  instances  the  definite  assistance  and  co- 
operation of  organized  labor  have  been  secured,  and  labor 
has  been  given  representation  in  the  training  and  employ- 
ment activities. 

Samuel  Gompers,  president  of  the  American  Federa- 
tion of  Labor,  has  made  the  following  statement  on  the 
attitude  of  the  trade  unionists: 

Organized  labor  is  wholeheartedly  with  the  purpose  of  helping 
disabled  soldiers  and  sailors  to  carry  on  as  self-reliant,  produc- 
tive members  of  society.  To  men  who  have  risked  their  lives 
for  this  Republic,  we  owe  it  s  a  duty  to  protect  against  depen- 
dency and  the  deteriorating  consequences^  of  lack  of  vocational 
training. 

Labor  is  concerned  as  to  the  rehabilitation  of  disabled  soldiers 
and  sailors  not  only  for  humanitarian  social  reasons  but  because 
of  the  detrimental  economic  consequences  that  would  result 
from  failure  to  return  these  men  as  resourceful,  able  members 
of  society,  restored  in  purpose  and  in  skill. 

Labor  desires  to  help  in  providing  proper  facilities  under 
civilian  control  for  the  training  of  these  men  as  well  as  to  co- 
operate in  returning  them  to  industry,  agriculture,  and  com- 
merce where  they  can  perform  real  service  under  such  conditions 


84  THE      DISABLED      SOLDIER 

as  will  safeguard  their  best  interests  as  well  as  those  of  fellow 
workers. 

Labor  fully  appreciates  the  value  of  the  principles  of  freedom 
involved  in  this  war  and  desires  to  do  everything  within  its 
power  to  assure  justice  to  those  who  render  service  to  the  cause. 

One  of  the  leading  labor  authorities  in  Great  Britain, 
G.  J.  Wardle,  a  member  of  Parliament,  states  that  the 
Labor  Party  strongly  favors  the  opening  up  of  every 
possible  avenue  of  instruction,  not  only  to  disabled  men 
who  had  no  particular  trade  before  they  joined  the 
colors,  but  also  to  those  already  trained  whose  wage- 
earning  capacity  can  be  increased  by  further  instruction. 
"Subject  to  there  being  no  diminution  in  the  standard  of 
living,  or  possibility  of  the  disabled  man  being  used  to 
defeat  the  legitimate  objects  which  the  trade  unions 
have  in  view"  there  is  not  only  sympathy  with  the 
cause,  but  a  very  definite  desire  to  "assist  the  disabled 
man  in  every  possible  way  to  secure  employment  on 
remunerative  work." 

The  unions  acknowledge  a  very  definite  responsibility 
to  their  own  members  who  return  disabled  from  the 
front,  and  have  promised  to  do  everything  in  their  power 
to  replace  them  in  the  industry  or  arrange  for  their  re- 
education. The  typographical  union  in  Toronto  has 
paid  for  the  training  of  some  of  its  own  disabled  mem- 
bers, formerly  hand  compositors,  as  typesetting  machine 
operators.  In  France  some  syndicats  or  unions  have 
organized  schools  of  re-education. 

For  the  more  helpless  to  whom  is  not  possible  employ- 
ment in  factories  or  mercantile  establishments  either  at 
a  reduced  or  standard  wage,  there  is  possible  work  either 
in  a  special  subsidized  workshop  or  at  home.  In  the 
special  shop  the  work  in  general  and  certain  operations 


ATWORKAGAIN  85 

in  particular  can  be  adapted  to  the  limitations  of  the 
handicapped  workers.  If  the  capital  expense  and  over- 
head are  publicly  or  philanthropically  defrayed,  such  an 
institution  can,  from  the  proceeds  of  its  product,  pay 
for  wages  and  materials. 

An  example  of  this  type  of  organization  is  the  Incor- 
porated Soldiers  and  Sailors  Help  Society  which  came 
into  being  in  England  at  the  close  of  the  South  African 
war  to  provide  employment  for  disabled  men.  Its  work 
was  greatly  enlarged  in  consequence  of  the  European 
war,  and  a  series  of  "Lord  Roberts  Workshops"  estab- 
lished in  various  British  cities.  The  sale  of  product  is 
based  largely  upon  considerations  as  to  source  and 
manner  of  manufacture. 

Such  an  organization  is  most  necessary  and  helpful; 
it  is  highly  important,  however,  that  men  be  admitted 
to  it  only  as  a  last  resort  after  every  possibility  of  fitting 
for  employment  in  regular  channels  has  failed.  The 
man  who  can  be  put  to  work  under  normal  conditions 
should  not  be  segregated  with  disabled  men  exclusively. 

The  soldier  disabled  too  seriously  even  for  work  in  a 
special  shop  or  factory  should  be  returned  to  his  own 
home  if  he  has  family  or  relatives  prepared  to  take  care 
of  him,  rather  than  sent  to  a  home  for  incurables,  to 
live  out  his  life  amidst  a  colony  of  unfortunates.  If 
possible  he  should  be  provided  with  work  which  will 
keep  him  busy  and  provide  some  modest  financial  return, 
which  will  prove  to  the  shut-in  a  great  incentive  and 
satisfaction. 

The  case  of  the  shut-in  child  or  adult  who  has  no 
work  to  occupy  the  hours  of  his  long  days  is  indeed 
hopeless.  A  worker  in  a  New  York  City  organization 
that  is  interested  in  the  welfare  of  the  crippled  shut-in 


86  THE      DISABLED      SOLD  I  E  R 

child  and  adult  tells  of  the  case  of  a  man  sixty  years  old 
who  was  hit  by  a  truck  and  suffered  the  amputation  of 
both  legs  in  consequence.  His  lot  appeared  desperate 
until  a  paper  novelty  company  provided  work  for  him 
that  he  could  do  at  home.  The  first  week  the  man  earned 
three  dollars — a  fortune  it  seemed  to  him,  for  he  had 
given  up  all  hope  of  ever  being  a  productive  worker  again. 
With  ambition  rekindled,  he  built  a  workbench  for 
himself,  and  was  able  to  do  considerable  work  at  glueing 
and  pasting  and  increased  his  earning  capacity  little  by 
little.  He  took  especial  pride  in  the  fact  that  he  could 
purchase  sweets  for  his  wife  out  of  his  earnings. 

Some  fairly  satisfactory  forms  of  home  work  can  be 
found  if  pains  are  taken  in  their  selection,  and  there  is 
some  effort  to  secure  the  work  from  manufacturers. 
With  a  little  simple  training  of  the  workers  it  may  be 
possible  to  induce  the  sending  out  of  work  not  ordinarily 
so  handled.  There  is  necessary,  of  course,  organization 
to  obtain  the  work,  transport  it  to  the  worker,  check 
the  quality  of  the  workmanship,  return  the  product  to 
the  manufacturer,  bargain  for  rates  of  pay,  and  effect 
financial  settlement. 

Some  of  the  most  successful  subjects  of  home  work 
already  found  in  very  limited  civilian  experience  in  seek- 
ing occupation  for  cripples  of  both  sexes  are  toy  painting 
and  finishing,  powder  puff  making,  glove  manufacturing 
and  trimming,  preparation  of  paint  and  varnish  samples, 
tag  and  label  stringing,  paper  novelty  work,  brush- 
making,  and  apron  stitching  and  finishing.  It  is  likely 
that  many  more  satisfactory  can  be  discovered. 

Many  a  disabled  soldier  whose  thoughts  never  turned 
to  a  life  in  the  open  may  be  tempted,  by  the  inducements 
held  out  by  his  government,  to  settle  on  the  land.     A 


AT      WORK      AGAIN 87 

free  homestead,  a  generous  loan  of  money  on  easy  pay- 
ments, a  set  of  implements  for  his  new  occupation — 
these  offers  may  open  new  vistas  to  the  ex-soldier  whose 
work,  before  the  war,  kept  him  in  the  factory  or  in  the 
office. 

Thus,  in  France,  a  law  was  recently  passed  providing 
that  disabled  soldiers  may  be  granted  loans  up  to  ten 
thousand  francs,  at  an  interest  charge  of  one  per  cent, 
for  the  acquisition  or  improvement  of  small  holdings. 

In  England,  it  is  planned  to  settle  returned  soldiers, 
in  general,  in  large  colonies  of  small  holdings,  to  be 
created  by  the  state.  As  an  experiment  of  the  practi- 
cability of  this  scheme,  a  Small  Holding  Colonies  Act, 
passed  in  1916,  empowered  the  Board  of  Agriculture  to 
acquire  in  England  and  Wales  up  to  6,000  acres  of  land, 
for  the  purpose  of  providing  experimental  small  holding 
colonies.  Scottish-American  societies  have  established 
several  garden  settlements  for  men  maimed  in  the 
war. 

Plans  are  also  being  made  for  an  extensive  settlement 
of  returned  British  soldiers  in  the  oversea  dominions. 
To  ascertain  what  facilities  the  dominions  were  prepared 
to  offer  in  this  regard,  Sir  Rider  Haggard  undertook  in 
1916,  on  behalf  of  the  Royal  Colonial  Institute,  a  journey 
throughout  the  dominions.  In  most  of  them  the  govern- 
ments declared  their  readiness  to  give  the  British  soldiers 
the  same  facilities  as  regards  settlement  on  land  as  the 
soldiers  of  their  own  military  forces. 

The  Canadian  Soldier  Settlement  Act,  passed  last  year, 
establishes  a  soldiers'  settlement  board  which  may 
recommend  to  the  Minister  of  the  Interior  reservation 
of  dominion  crown  lands.  The  minister  may  grant  to 
discharged  soldiers  or  sailors  of  Canada,   the  United 


88  THE      DISABLED      SOLDIER 

Kingdom,  or  any  self-governing  dominion  free  entry  of 
not  over  160  acres  of  this  reserved  land.  An  order-in- 
council  has  reserved  for  the  settlement  of  returned  sol- 
diers all  vacant  and  available  dominion  lands  within 
fifteen  miles  on  either  side  of  railways  in  the  districts 
where  sufficient  land  is  available  for  settlement  on  a 
large  scale.  The  board  may  also  grant  loans  not  exceed- 
ing $2,500  to  the  settlers  for  the  acquisition  or  improve- 
ment of  land,  the  payment  of  incumbrances,  erection  of 
farm  buildings,  etc.  The  loans  shall  be  at  five  per  cent., 
and  the  principal  shall  be  repaid  in  twenty  annual  instal- 
ments. Payment  of  the  first  two  instalments  may  be 
deferred  by  the  board.  The  loan  is  to  be  expended  under 
the  supervision  of  the  board;  it  is  granted  in  the  form 
of  warrants  for  expenditures,  which  are  honored  by  the 
banks  as  checks.  The  board  is  authorized  also  to  provide 
for  the  training  of  returned  soldiers  on  farms,  for  the 
creation  of  agricultural  training  stations,  for  the  appoint- 
ment of  instructors  and  inspectors,  and  for  training  in 
domestic  and  household  science  for  the  settlers'  wives. 

The  Canadian  Pacific  Railway  Company  has  also 
worked  out  a  scheme  for  the  settlement  of  returned 
soldiers  on  the  lands  which  it  owns  in  the  western 
provinces  of  Canada.  The  settlement  may  be  either  on 
"improved  farms"  in  colonies  selected  by  the  company, 
or  under  an  "assisted  colonization"  system,  where  the 
settler  selects  his  own  land  from  any  of  the  company's 
unsold  land.  The  cost  is  to  be  repaid  in  twenty  instal- 
ments, with  interest  at  five  per  cent. 

In  Australia  the  conference  of  the  premiers  of  the 
several  states  in  January,  1917,  adopted  a  general  plan 
which  aims  at  settling  on  land  40,000  returned  soldiers 
and  sailors,  Australian  and  British.    The  scheme  is  based 


AT      WORK      AGAIN 89 

upon  the  cooperation  of  the  commonwealth  and  the 
states;  the  latter  are  to  supply  the  land,  since  the  crown 
lands  are  owned  by  the  several  states,  and  the  former  is 
to  provide  the  necessary  funds.  The  Federal  govern- 
ment promised  to  raise  £20,000,000  by  loan,  to  be  devoted 
to  land  settlement.  Out  of  the  Federal  Fund,  an  advance 
of  £500  for  improvements  may  be  made  to  the  settler, 
on  very  easy  repayment  terms,  the  first  annual  instal- 
ment being  of  three  and  one-half  per  cent.  only.  The 
several  states  have  enacted  legislation  to  help  the  settle- 
ment of  returned  soldiers.  New  South  Wales,  which  has 
over  two  million  acres  available,  transfers  the  land  to 
the  soldiers  for  an  annual  five  per  cent,  interest  charge 
with  one  per  cent,  for  amortization ;  the  total  charge  will 
be  redeemed  in  thirty-eight  years.  The  state  may  also 
advance  to  the  settler  £500,  reserving  the  right  to  super- 
vise the  expenditures,  and  provides  for  him  also  educa- 
tional and  advisory  aid.  The  state  of  Queensland  has 
reserved  all  public  lands  for  returned  soldiers;  there  will 
be  no  rent  charge  for  several  years;  then  for  twelve 
years  the  rent  will  be  one  and  one-half  per  cent,  of  the 
capital  value;  later  the  rent  charge  will  be  fixed  by 
rent-courts.  Loans  may  be  granted  up  to  £500,  at  an 
initial  rate  of  three  and  one-half  per  cent.,  gradually 
increasing  to  five  per  cent.;  the  loans  are  repayable  in 
forty  years.  Other  states,  which  have  no  public  lands 
of  sufficient  fertility  available  must  necessarily  purchase 
land  for  soldier  settlement.  Thus  in  Tasmania  the  gov- 
ernment purchases  large  estates  and  divides  them  into 
small  holdings;  the  money  advanced  by  the  common- 
wealth is  used  for  improvements.  The  state  government 
may  also  provide  the  settler  with  live  stock  to  the  value 
of  £150  and  with  advances  in  cash  up  to  £500  for  build- 


90  THE      DISABLED      SOLDIER 

ings.  All  the  sums  expended  are  repaid  in  small  annual 
instalments. 

In  New  Zealand,  the  Governor  may  from  time  to  time 
reserve  any  area  of  crown  land  for  the  settlement  of 
discharged  soldiers.  The  holdings  may  be  leased  or  sold 
to  the  applicants  on  terms  decided  upon  by  the  Land 
Board;  upon  the  recommendation  of  the  latter,  the 
Minister  of  Lands  may  also  grant  loans  to  the  settlers. 

In  Germany  the  periodical  pension  payments  may  be 
commuted  to  a  lump  payment  to  enable  the  disabled 
soldier  to  settle  on  the  land  and  undertake  farming. 
In  Prussia,  where  the  government  has  been  active  for 
twenty-five  or  thirty  years  in  promoting  the  creation  of 
small  holdings,  the  disabled  soldier  can  take  advantage 
of  the  old  legislation  regarding  the  so-called  "rent-fee 
holdings";  these  are  farms  transferred  to  the  settler, 
with  the  help  of  the  state  annuity-banks,  against  an 
annual  rent  charge  redeemable  in  about  sixty  years.  To 
help  the  settlement  of  disabled  soldiers,  similar  legislation 
has  been  enacted  during  the  war  in  some  other  German 
states,  as  in  Bavaria  and  in  the  Duchy  of  Brunswick. 

In  the  United  States  the  Secretary  of  the  Interior  is 
planning  similar  provision.  As  most  of  the  desirable 
public  lands  have  already  been  taken  up,  it  is  proposed 
to  reclaim  for  soldier  settlement  territory  which  is  now 
of  no  value,  but  which  can  be  made  fertile  and  productive. 

Historically,  one  of  the  most  lucrative  fields  for  the 
employment  of  the  ex-soldier  has  been  the  public  service, 
either  by  political  appointment  or  under  civil  service 
control.  After  the  Civil  War  one  of  the  greatest  handi- 
caps to  the  efficiency  of  national  departments  was  the 
"veteran  preference"  legislatively  enjoined,  and  many 
discharged  soldiers  received  jobs  for  which  they  were 


ATWORKAGAIN  91 

not  capable.  Taking  men  into  jobs  on  this  basis  is  just 
another  form  of  charity,  and  as  this  is  now  being  dis- 
couraged on  the  part  of  private  employers,  so  should 
it  be  reprehended  on  the  part  of  the  state. 

The  civil  service  authorities  should  be  asked,  not  to 
burden  their  list  of  appointments  with  men  unfitted  to 
the  jobs  in  which  they  are  placed,  but  merely  to  revise 
some  of  their  rulings  so  as  not  to  discriminate  against 
the  disabled  as  regards  positions  for  which  they  are 
qualified.  They  may  properly  give  preference  to  an  ex- 
soldier  when  all  other  things  are  absolutely  equal — but 
not  otherwise.  This  is  the  fairest  course  toward  the 
disabled  applicants  themselves. 

Many  civil  service  commissions  have,  in  the  past, 
refused  to  permit  crippled  men  to  sit  for  any  examina- 
tions, even  when  their  disability  would  be  no  handicap 
whatever  in  the  position  sought.  The  one-legged  but 
expert  electrician  has  been  barred  from  employment  in 
the  alarm  division  of  the  fire  department ;  the  one-armed 
cost  accountant  has  been  excluded  from  candidacy  for 
an  inside  clerical  job.  Even  in  the  national  crisis  of  war 
it  has  been  impossible  for  one  highly  skilled  wireless 
operator,  with  a  leg  amputated,  to  gain  employment  in 
government  service.  If  the  authorities  preach  to  indi- 
vidual employers  an  end  of  arbitrary  and  unjust  dis- 
crimination against  the  disabled,  the  change  in  practice 
should  begin  at  home. 

In  France  certain  suitable  posts  in  the  government 
service  or  in  enterprises  benefiting  by  concessions  from 
the  state  have  been  reserved  for  disabled  soldiers.  In 
Canada  the  returned  man  has  preference  in  civil  service 
appointments,  and  a  great  many  of  the  re-educational 
classes  prepare  men  for  jobs  in  the  revenue  and  postal 


92  THE      DISABLED      SOLDIER 

departments,  so  that  the  men  may  go  to  their  work  with 
preparation  adequate  to  ensure  success. 

After  a  disabled  man  has  been  placed  in  employment 
he  should  be  followed  up  to  see  that  the  new  relation  is 
working  out  happily.  The  friendly  visitor  should  inter- 
view both  parties  at  interest:  the  employer  to  see  in 
what  ways,  if  any,  the  worker  is  not  giving  satisfaction; 
and  the  employee  to  ascertain  whether  he  considers  he 
is  being  treated  unfairly  or  not  being  given  the  best 
opportunity  to  make  good.  In  the  majority  of  instances 
the  difficulties  are  not  fundamental  and  may  often  be 
cleared  up  by  a  helpful  third  party,  where  the  will  to 
make  the  enterprise  succeed  is  present  on  both  sides. 

After  disablement  the  first  employment  is  a  new  ex- 
perience under  strange  conditions,  and  troubles  either 
real  or  imaginary  are  liable  to  arise.  Those  of  real  sub- 
stance, such  as  unsuitability  of  an  artificial  limb,  the 
lack  of  technical  preparation  for  a  certain  process  the 
worker  is  called  on  to  perform,  the  misunderstanding 
on  the  part  of  a  department  head  of  the  scope  of  work 
for  which  the  man  was  employed,  may  be  remedied  in 
the  appropriate  manner.  Those  having  their  existence 
only  in  imagination  are  more  difficult  of  adjustment. 
The  deaf  employee  is  sensitive  and,  not  being  able  to 
hear  the  conversation  of  his  fellow-workmen,  becomes 
convinced  they  are  criticizing  and  scheming  against  him. 
The  blind  man  presents  his  perfected  product  to  the 
taciturn  foreman  and  interprets  his  silence  or  ambiguous 
grunt  as  dissatisfaction.  In  both  these  instances  exactly 
the  opposite  situation  may  prevail,  but  it  may  require 
considerable  tact  in  the  demonstration. 

And  lastly,  where  the  job  offers  no  fair  remuneration 
for  the  present  nor  prospect  for  the  future,  or,  from  the 


ATWORKAGAIN  93 

man's  point  of  view,  is  for  other  reason  definitely  un- 
satisfactory, the  employment  should  be  terminated  at 
the  advice  of  the  visitor,  and  another  placement  made. 
An  employment  authority  will  often  send  men  to  jobs 
which  are  known  not  to  be  ideal,  but  the  position  should 
be  regarded  as  temporary  only  and  the  worker  recalled 
when  better  employment  is  available.  On  the  other 
hand,  where  an  employer — often  with  motives  of  good- 
will and  helpfulness — has  hired  a  disabled  man  on  rep- 
resentation that  he  can  competently  meet  the  require- 
ments of  the  job,  and  it  is  found  that  the  worker  is  failing 
to  do  so,  or  is  careless,  irresponsible,  and  not  trying  to 
do  his  duty,  then  he  should  be  removed  on  the  initiative 
of  the  same  organization  as  made  the  placement,  thus 
relieving  the  employer  of  the  embarrassment  of  dis- 
charging a  physically  handicapped  man.  The  general 
employment  interest  of  the  disabled  will  best  be  served 
by  such  a  policy.  This  is  particularly  being  recognized  in 
relation  to  the  blind,  present  placement  plans  providing 
for  recall  of  the  worker  who  is  misplaced  or  failing  to 
succeed.  The  average  employer  shrinks  from  discharging 
a  blind  man  and  may,  even  in  spite  of  incompetence, 
carry  him  on  the  payroll  for  several  years.  But  after 
one  experience  of  this  kind  he  will  take  good  care  indeed 
that  he  is  not  again  saddled  with  a  similar  embarrass- 
ment in  the  person  of  another  blind  employee. 

Quite  the  antithesis  of  the  policy  of  refitting  the  dis- 
abled man  for  return  to  the  regular  fields  of  industry  to 
find  employment  side  by  side  with  normal  workers — 
and  with  the  disability  assuming  progressively  a  role  of 
less  and  less  importance — is  a  proposal  recently  made 
in  England  to  provide  for  the  partially  disabled  through 
the  erection  of  a  system  of  industrial  villages  wherein 


94  THE      DISABLED      SOLDIER 

should  be  housed  and  employed  the  returning  physically 
handicapped  soldiers.  It  being  assumed  that  re-edu- 
cation has  been  provided  for,  there  is  proposed  the 
creation  of  an  exceptionally  favorable  environment  so 
that  the  results  of  training  "may  be  increased  a  hundred- 
fold," for  it  is  argued  that  if  the  crippled  men  "are 
compelled  to  carry  on  their  work  amid  the  evil  condi- 
tions so  often  existing  in  our  towns  however  well-housed 
in  home  and  workshop,  instead  of  in  the  villages  which 
it  is  our  desire  and  aim  to  see  placed  at  the  disposal  of 
employers  of  wounded  soldiers,  as  well  as  those  who 
work  at  independent  crafts,  we  shall  certainly  have  failed, 
as  a  nation  and  individually,  in  our  whole  duty  towards 
them."  The  proposal  is  to  build  up  model  villages,  either 
now  in  their  entirety  or  built  around  some  existing 
nucleus.  The  financial  suggestion  is  that  the  capital 
expenditure  be  financed  at  government  or  private  ex- 
pense, but  that  beyond  this  point  the  disabled  men 
should  pay  their  own  way.  It  is  expected  to  provide  a 
central  business  organization  which  would  arrange  for 
community  purchase  of  supplies  and  marketing  of 
products. 

Such  a  village,  from  the  ideal  point  of  view,  would 
assuredly  be  a  charming  place  in  which  to  live.  But 
whether  the  plan  would  work  is  open  to  some  question. 
The  best  test  of  all  proposals  for  disabled  men  is  to  con- 
sider whether  they  would  work  for  normal  men.  On 
this  criterion,  it  seems  unlikely  that  a  given  group  of 
men,  mostly  resident  in  large  cities,  could  be  persuaded 
in  spite  of  apparent  inducements  to  leave  their  present 
homes  and  social  ties,  and  move  with  their  families  to 
a  new  locality.  Certainly  they  would  not  do  so  unless 
satisfactory  employment  were  certain  indeed. 


ATWORKAGAIN  95 

It  is  proposed  that  the  village  be  planned  and  built 
around  a  dominant  industry.  By  showing  of  actual  ex- 
perience no  industry  could  be  found  which  would  suit 
any  considerable  proportion  of  disabled  soldiers.  The 
principles  of  their  re-education  call  for  training  in  the 
same  line  as  that  in  which  they  were  previously  em- 
ployed or  in  a  line  very  closely  related.  The  number  of 
training  subjects  is  constantly  on  the  increase.  For 
example,  in  Canada,  disabled  men  are  being  taught 
ninety-seven  different  vocations.  No  village  would 
supply  employment  of  such  wide  range. 

It  is  on  the  social  considerations  involved,  however, 
that  must  be  taken  most  definite  issue.  The  plan  calls 
for  the  segregation  of  a  special  class,  a  policy  which  has 
been  rejected  in  modern  work  of  social  character.  In 
the  statement  of  the  plan  this  criticism  is  anticipated, 
and  it  is  argued  that  disabled  men  will  be  happier  in 
their  own  company  than  when  struggling  under  real  or 
imaginary  odds  against  able-bodied  competitors.  The 
answer  is  that  true  happiness  comes  with  replacement 
in  normal  employment,  working  side  by  side  on  an  even 
footing  with  normal  operatives.  The  aim  of  re-education 
is  to  turn  out  the  soldier  as  a  skilled  worker  in  a  job  at 
which  his  disability  is  no  handicap.  Will  the  one-legged 
man  be  better  off  in  a  colony  of  cripples  or — after  thor- 
ough training  as  a  telegrapher,  monotype  operator,  or  me- 
chanical draftsman — in  employment  secured  through 
standard  channels? 


96  THE      DISABLED      SOLDIER 


CHAPTER  VII 

HELP  OR  HINDRANCE 

Though  the  re-educational  provision  may  be  excellent, 
and  though  the  will  and  spirit  of  the  men  under  training 
may  be  of  the  best,  yet  the  complete  success  of  a  pro- 
gram of  rehabilitation  will  depend  upon  whether  the 
attitude  of  the  public  acts  as  a  help  or  a  hindrance — 
upon  whether  the  influence  on  the  individual  ex-soldier 
of  his  family,  his  employer,  and  the  community  at  large 
is  constructive  or  demoralizing. 

What,  then,  is  the  public  duty  toward  the  disabled 
soldier?  For  it  is  certain  that  the  requirements  need 
only  to  be  understood  to  be  fulfilled. 

The  first  responsibility  on  the  part  of  the  family  of 
the  injured  man  is  to  learn  the  meaning  of  disability, 
and  see  the  hopeful  rather  than  the  depressing  aspect. 
Just  recently,  in  the  suburb  of  a  large  Pennsylvania  city, 
a  woman  in  a  swoon  was  found  on  the  steps  of  the  local 
postoffice.  She  had  just  opened  a  letter  from  her  son 
at  the  front  which  told  of  a  gunshot  injury  necessitating 
amputation  of  his  left  arm  below  the  elbow.  Imme- 
diately there  rose  before  her  eyes  the  terrifying  prospect 
of  a  life  of  idleness  and  possible  pauperism.  One  can 
imagine  what  her  next  letter  would  be  like:  saying  she 
knows  what  the  amputation  means  and  sympathizes 
most  tenderly  on  account  of  what  must  be  faced  in  the 
future.  If  it  were  only  a  leg,  it  would  not  be  so  bad  for 
then  he  might  be  able  to  take  care  of  himself  and  get 
some  kind  of  a  job,  but  with  an  arm  off  he  could  not 


HELP      OR      HINDRANCE  97 

expect  to  do  that.  But  she  and  father  have  saved  up 
some,  and  with  uncle's  help  they  will  take  care  of  him 
till  the  end  of  his  days.  Picture  the  influence  of  this 
message  in  comparison  with  another  which  might  be 
sent  in  the  light  of  a  fuller  understanding  of  what  is 
possible:  "I  have  just  heard  of  your  arm  amputation 
and  sympathize  most  lovingly  in  your  loss.  But  I 
know  you  will  not  lose  your  courage,  even  at  this  sacrifice 
for  your  country.  Even  now,  the  national  authorities 
are  making  plans  to  make  up  so  far  as  possible  for  such 
losses,  as  you  doubtless  already  well  know.  One-armed 
men  can  be  trained  for  skilled  jobs,  especially  men  with 
native  ability  such  as  yours,  and  the  training  is  already 
under  way  in  the  city  near  us.  The  employers  also 
here  are  becoming  tremendously  interested  in  the  sub- 
ject, are  finding  jobs  specially  suited  to  men  who  have 
lost  arms  or  legs,  and  have  promised  these  jobs  to  the 
fellows  who  return  from  the  front  disabled.  And  you 
can  count  on  our  standing  behind  you  at  every  step  and 
helping  in  every  way  we  can.  This  is  really  a  fine  future 
to  look  ahead  to,  for  if  you  make  good  here  at  home  with 
your  handicap  of  honor,  you  and  we  will  have  true 
reason  to  be  proud.  And  of  course  you  will  succeed  if 
you  go  at  this  obstacle  with  the  same  spirit  and  nerve  as 
have  gone  toward  your  work  in  the  army.  Your  mother 
will  look  forward  to  seeing  you  return  home,  wearing  the 
uniform  of  Uncle  Sam  and  flying  the  colors  of  a  soldier 
who  can't  be  beaten." 

It  is  greatly  to  be  desired  that  the  families  of  men 
going  to  the  front  should  know  of  the  possibilities  of 
re-education  and  re-employment  and  of  the  provision 
being  made  for  the  disabled,  for  it  would  mitigate  not 
only  a  great  deal  of  mental  suffering  over  actual  injuries 


98  THE      DISABLED      SOLDIER 

but  over  prospective  disabilities  as  well.  It  is  well 
known  that  the  greatest  fear  regarding  service  in  the 
trenches  is  not  the  loss  of  life  but  the  prospect  of  return- 
ing crippled.  As  one  writer  has  well  put  it:  "To  die 
for  one's  country;  if  one  could  only  be  sure  of  dying!" 
In  coming  down  in  the  elevator  of  a  large  New  York 
department  store  recently,  the  day  following  the  pub- 
lication in  its  pictorial  section  by  a  great  daily  newspaper 
of  the  photograph  of  the  first  American  amputation 
cases  in  France,  the  following  remark  was  overheard: 
"Did  you  see  those  horrible  pictures  in  the  paper  yester- 
day? I  do  hope  that  Jack  will  not  come  home  that  way; 
I  would  rather  he  be  killed."  Yet  the  picture  showed 
only  foot  amputations,  and  to  one  familiar  with  cripples 
and  their  potential  accomplishments  such  a  disability 
seems  a  real  inconvenience  but  nothing  more.  The 
woman  quoted  was  suffering  unduly  in  her  apprehension. 

It  is  not  here  intended  to  minimize  the  seriousness  of 
the  total  disabilities,  but  these  occur  in  but  one  case  in 
a  hundred  thousand.  The  point  is  that  many  injuries 
that  might  be  regarded  as  terrible  under  unintelligent 
handling  in  the  past  no  longer  remain  so. 

The  second  responsibility  of  the  family  is  to  under- 
stand the  importance  to  the  disabled  soldier  of  the  prof- 
fered training  for  self-support,  and  to  encourage  him 
in  every  possible  way  to  undertake  it.  The  family  must 
do  more  than  avoid  opposition  to  the  soldier's  plan  for 
re-education;  they  must  do  more  than  give  it  lukewarm 
assent — they  must  get  behind  it  with  every  influence  at 
their  command. 

Failure  to  have  the  family  understand  and  support 
the  program  for  the  future  of  the  disabled  man  may 
have  disastrous  results.    In  France  the  mother  occupies 


HELP      OR      HINDRANCE  99 

an  unusual  place  of  authority  in  the  family  economy. 
A  son  may  grow  up  to  be  twenty,  thirty,  or  forty  years 
old,  but  mother  is  still  a  chief  to  whom  obedience  is  un- 
questionably paid.  In  dealing  with  the  poilu,  therefore, 
one  must  count  on  his  maternal  parent  as  well.  At  one 
French  center  of  hospital  care  and  re-education  it  was 
found  that  as  a  man  would  approach  the  point  of  his 
medical  recovery  and  approach  the  time  of  entry  on 
vocational  training,  his  mother  was  liable  to  descend 
upon  the  hospital  office,  beat  her  umbrella  on  the  table, 
inquire  why  they  were  keeping  her  son  so  long  away 
from  home,  and  demand  his  immediate  discharge  in 
order  that  she  might  take  him  away  "to  care  for  the 
poor  crippled  boy  for  the  rest  of  his  life."  In  vain  were 
explanations  and  arguments  regarding  the  efficacy  of 
further  treatment  and  training.  She  had  come  there 
determined  to  take  her  son  away,  and  the  scene  would 
continue  until  her  end  was  accomplished.  And  in  most 
instances  there  was  nothing  to  do  but  accede  to  the 
mother's  demand. 

But  a  better  way  was  found  of  dealing  with  the 
families  of  men  deemed  likely  to  benefit  by  re-education. 
Under  this  procedure,  when  the  soldier  was  nearing  the 
end  of  his  hospital  care,  the  director  of  the  institution 
would  summon  the  mother  to  come  in  and  advise  re- 
garding her  son's  future.  She  would  then  be  addressed 
something  in  this  wise:  "Your  son's  medical  treatment 
will  in  another  week  or  two  be  practically  complete, 
and  we  thought  you  might  like  to  know  so  that,  if  you 
desired,  you  could  make  plans  to  take  him  home.  But 
you  know  he  is  permanently  disabled  and  will  not  be 
able  to  go  back  to  his  old  job  of  telegraph  lineman.  We 
know  that  you  expect  to  care  for  him,  but  he  will  outlive 


100  THE      DISABLED      SOLDIER 

you,  and  later,  since  the  government  pension  is  small 
indeed,  he  will  be  reduced  to  a  miserable  situation.  You 
remember  the  cripples  from  the  war  of  1870,  how  they 
begged  or  sold  trinkets  about  the  streets — and  you 
would  not  want  your  son  to  be  in  that  fix.  Luckily, 
however,  he  will  not  have  to  be  for  we  have  something 
else  to  suggest.  Across  the  street  is  a  school  where  the 
men  are  taught  various  skilled  trades.  If  your  son 
cares  to  stay  for  five  or  six  months,  and  you  approve, 
we  will  teach  him  to  be  a  telegrapher  and  he  can  go  back 
to  his  home  town  and  get  a  good  job  with  the  govern- 
ment telegraphs.  As  a  skilled  worker  still  he  will  be 
doubly  respected  in  the  community,  he  will  be  a  burden 
on  no  one,  his  future  will  be  assured,  and  you  will  be 
very,  very  proud  of  him.  What  do  you  think  wise 
under  the  circumstances?" 

The  whole  situation  is  changed.  Mother  greets  her 
boy  with:  "Son,  have  you  heard  what  they  are  going  to 
do  for  you?"  And  as  the  son  has  already  been  talked 
to  regarding  the  program,  the  joint  decision  is  assured. 

This  illustrates  the  difference  between  a  family  for 
or  a  family  against  the  proposal  of  re-education. 

The  third  duty  of  the  family  is  to  stand  behind  the 
man  during  his  course  of  training  and  try  in  every  way 
to  encourage  rather  than  dishearten  him.  Letters  from 
home  which  recite  all  the  troubles  of  life  and  none  of 
the  joys  will  not  help  the  enterprise.  The  family  re- 
action should  rather  be:  "Stick  to  it;  we  are  getting 
along  all  right  and  want  to  see  you  finish  the  job  up 
right,  now  that  you  are  at  it."  In  other  words,  it  is 
necessary  to  maintain  the  morale  of  the  family  in  the 
same  way  as  when  the  man  is  at  the  front.  This  is 
largely  contributed  to  by  home  visitors  such  as  those 


HELP      OR      HINDRANCE  101 

of  the  Canadian  Patriotic  Fund  or  the  American  Red 
Cross. 

The  fourth  family  responsibility  toward  the  disabled 
man  is  to  make  the  home  influence  as  sensible  and  as 
truly  helpful  as  possible  after  his  return  from  hospital 
or  school.  The  first  and  very  natural  impulse  when  son 
or  husband  comes  home  crippled  or  blind  is  to  pet  him 
and  wait  on  him  hand  and  foot.  Yet  the  best  interests 
of  the  family  as  well  as  of  the  man  himself  demand  his 
being  encouraged  to  do  for  himself  everything  he  can, 
with  the  aim  of  stimulating  that  self-dependence  which 
has  been  the  object  of  his  whole  course  of  training. 
Within  the  limits  imposed  by  affection  the  family 
should  endeavor  to  carry  along  the  spirit  of  that  training. 

In  the  readjustment  of  the  crippled  soldier  to  civilian 
life  the  employer  has  a  very  definite  responsibility.  But 
this  duty  is  not  entirely  obvious.  It  is,  on  the  contrary, 
almost  diametrically  opposite  to  what  one  might  super- 
ficially infer  it  to  be.  The  duty  is  not  to  "take  care  of," 
from  patriotic  motives,  a  given  number  of  disabled  men, 
finding  for  them  any  odd  jobs  which  are  available,  and 
putting  the  ex-soldiers  in  them  without  much  regard  to 
whether  they  can  earn  the  wages  paid  or  not. 

Yet  this  method  is  all  too  common.  A  local  committee 
of  employers  will  deliberate  about  as  follows:  "Here 
are  a  dozen  crippled  soldiers  for  whom  we  must  find 
jobs.  Jones,  you  have  a  large  factory;  you  should  be 
able  to  take  care  of  six  of  them.  Brown,  can  you  not 
find  places  for  four  of  them  in  your  warehouse?  And 
Smith,  you  ought  to  place  at  least  a  couple  in  your 
store," 

Such  a  procedure  cannot  have  other  than  pernicious 
results.    In  the  first  years  of  war  the  spirit  of  patriotism 


102  THE      DISABLED      SOLDIER 

runs  high,  but  experience  has  shown  that  men  placed 
on  this  basis  alone  find  themselves  out  of  a  job  after  the 
war  has  been  over  several  years,  or  in  fact,  after  it  has 
been  in  progress  for  a  considerable  period  of  time. 

A  second  weakness  in  this  method  is  that  a  man  who 
is  patronized  by  giving  him  a  charity  job,  comes  to 
expect  as  a  right  such  semi-gratuitous  support.  Such 
a  situation  breaks  down  rather  than  builds  up  character, 
and  makes  the  man  progressively  a  weaker  rather  than 
a  stronger  member  of  the  community. 

The  third  difficulty  is  that  such  a  system  does  not 
take  into  account  the  man's  future.  Casual  placement 
means  employment  either  in  a  make-shift  job  as  watch- 
man or  elevator  operator — such  as  we  should  certainly 
not  offer  our  disabled  men  except  as  a  last  resort — or 
in  a  job  beyond  the  man,  one  in  which,  on  the  cold- 
blooded considerations  of  product  and  wages,  he  cannot 
hold  his  own.  Jobs  of  the  first  type  have  for  the  worker 
a  future  of  monotony  and  discouragement.  Jobs  of  the 
second  type  are  frequently  disastrous,  for  in  them  a  man, 
instead  of  becoming  steadily  more  competent  and  build- 
ing up  confidence  in  himself,  stands  still  as  regards  im- 
provement and  loses  confidence  every  day.  When  he  is 
dropped  or  goes  to  some  other  employment,  the  job  will 
have  had  for  him  no  permanent  benefit. 

Twelve  men  sent  to  twelve  jobs  may  all  be  seriously 
misplaced,  while  the  same  twelve  placed  with  thought 
and  wisdom  and  differently  assigned  to  the  same  twelve 
jobs  may  be  ideally  located.  If  normal  workers  require 
expert  and  careful  placement,  crippled  candidates  for 
employment  require  it  even  more. 

The  positive  desideratum  is  to  find  for  the  disabled 
man  a  constructive  job  which  he  can  hold  on  the  basis 


HELP      OR      HINDRANCE  103 

of  competence  alone.  In  such  a  job  he  can  be  self- 
respecting,  be  happy,  and  look  forward  to  a  future. 
This  is  a  duty  not  so  easy  of  execution  as  telling  a  super- 
intendent to  take  care  of  four  men,  but  there  is  in- 
finitely more  satisfaction  to  the  employer  in  the  results, 
and  infinitely  greater  advantage  to  the  employee.  And 
it  is  entirely  practical,  even  in  dealing  with  seriously 
disabled  men. 

Thousands  of  cripples  are  now  holding  important  jobs 
in  the  industrial  world.  But  they  are  men  of  exceptional 
character  and  initiative  and  have,  in  general,  made  their 
way  in  spite  of  employers  rather  than  because  of  them. 
Too  many  employers  are  ready  to  give  the  cripple  alms, 
but  not  willing  to  expend  the  thought  necessary  to  place 
him  in  a  suitable  job.  This  attitude  has  helped  to  make 
many  cripples  dependent.  With  new  responsibilities  to 
the  disabled  soldier,  the  point  of  view  must  certainly  be 
changed.  What  some  cripples  have  done,  other  cripples 
can  do — if  only  given  an  even  chance. 

This,  then,  constitutes  the  charge  of  patriotic  dutj' 
upon  the  employer: 

To  study  the  jobs  under  his  jurisdiction  to  determine 
what  ones  might  be  satisfactorily  held  by  cripples.  To 
give  the  cripples  preference  for  these  jobs.  To  consider 
thoughtfully  the  applications  of  disabled  men  for  em- 
ployment, bearing  in  mind  the  importance  of  utilizing 
to  as  great  an  extent  as  possible  labor  which  would 
otherwise  be  unproductive.  To  do  the  returned  soldier 
the  honor  of  offering  him  real  employment,  rather  than 
proffering  him  the  ignominy  of  a  charity  job. 

The  responsibility  to  the  disabled  soldier  on  the  part 
of  the  community  at  large  is  much  more  complex,  since 
the  contact  exists  at  a  multitude  of  points  and  is  at 


104 THE      DISABLED      SOLDIER 

none  highly  intimate.  The  first  reaction  of  the  public 
to  the  returning  man  is  hero-worship  of  the  most  empty 
type — described  coldly,  it  usually  consists  in  making  a 
fool  of  the  man  and  entertaining  him  in  inappropriate 
and  hurtful  ways. 

One  form  of  this  is  society  lionization — and  for  but 
the  proverbial  six  days  indeed.  To  a  large  Canadian 
city  there  returned  a  disabled  soldier  after  two  years* 
absence  at  the  front.  His  wife  and  children  had  been 
looking  forward  expectantly  to  having  him  with  them, 
but  after  his  arrival  saw  but  little  of  the  head  of  the 
house.  As  a  national  holiday  was  approaching,  they 
were  counting  on  his  accompanying  them  to  the  park, 
and  had  exacted  a  tentative  promise  that  he  would  do 
so.  But  as  the  morning  arrived  and  mother  was  dressing 
the  children  to  start,  father  made  no  move  to  get  ready. 
Almost  tearfully  mother  asked  if  he  was  not  going  with 
them.  "Oh,  no,"  he  answered,  "I  am  going  for  an  auto- 
mobile ride  this  morning  and  this  afternoon  to  a  sing- 
song at  the [naming  a  fashionable  hotel]."    This 

was  the  way  in  which  the  community  was  showing  kind- 
ness to  the  returned  soldier  and  helping  to  put  him  back 
on  his  feet! 

The  man  on  the  street  thinks  the  greatest  service  to 
the  disabled  fighter,  particularly  when  he  is  discharged 
from  the  army  and  no  longer  under  the  partial  protection 
of  the  khaki,  to  consist  in  buying  him  at  the  corner 
saloon  as  many  drinks  as  he  can  hold.  From  one  small 
American  city  a  social  worker  reported  inability  to  dis- 
tinguish as  to  whether  certain  discharged  men  were 
suffering  from  shell  shock  or  intoxication,  so  hearty  was 
the  hospitality  of  the  citizens.  Such  "kindness"  requires 
no  comment.    Fortunately  the  war-time  measure  regard- 


HELP      OR      HINDRANCE  105 

ing  the  liquor  trade  will  soon  make  this  impossible,  and 
will  guard  the  ex-soldier  from  one  pitfall.  It  may  be 
noted  in  passing  that  this  will  be  a  boon  to  the  returned 
men  in  more  ways  than  one.  In  Canada  at  a  time  when 
most  of  the  provinces  had  prohibition  and  one  or  two 
others  limited  license,  the  placement  of  disabled  men 
in  employment  was  many  times  simpler  in  the  dry  ter- 
ritory than  the  wet.  In  the  latter  many  men  lost  jobs 
again  and  again  by  reason  of  intoxication,  not  only  in- 
juring themselves,  but  weakening  the  standing  of  their 
fellows  as  well  in  the  eyes  of  the  employers. 

Finally,  there  is  the  great  general  public  prejudice 
against  the  disabled,  the  incredulity  as  to  possible  use- 
fulness, the  apparent  will  to  pauperize,  and  the  reluc- 
tance through  usual  channels  of  opportunity  to  give  the 
handicapped  man  a  chance.  Successful  crippled  and 
blind  men  unanimously  testify  that  the  handicap  of 
public  opinion  is  a  greater  obstacle  than  amputation  of 
limb  or  loss  of  sight.  And  this  unenlightened  attitude 
is  manifest  in  every  social  relation  of  the  disabled — with 
family,  with  employer,  with  the  community  as  a  whole. 

It  becomes  clear,  therefore,  that  a  necessary  feature 
of  any  program  for  restoring  the  disabled  soldier  to 
self-resf)ect  and  self-support  is  a  campaign  of  public 
education  to  convert  the  general  attitude  toward  the 
crippled  and  handicapped. 

This  need  was  recognized  most  clearly  among  our 
enemies  by  Germany  and  among  our  allies  by  Canada. 
There  was  signal  failure  to  appreciate  the  value  of  public 
education  in  France,  Great  Britain,  and  Italy.  There 
is  no  need  of  it  yet  in  Belgium  as  all  the  disabled  men 
are  retained  in  the  army  and  provided  not  only  with 


106  THE      DISABLED      SOLDIER 

training  but  with  employment  as  well,  and  there  is  no 
family  problem  as  the  men  cannot  return  home. 

Within  a  few  months  of  the  opening  of  the  war,  the 
secretary  of  the  German  national  federation  for  the  aid 
of  cripples  made  a  tour  of  the  leading  cities  of  the 
Fatherland  speaking  to  meetings  of  public  officials, 
social  workers,  and  the  like,  with  the  aim  of  disseminating 
intelligence  regarding  modern  principles  and  methods 
of  dealing  with  the  disabled.  The  same  authority  pre- 
pared several  pamphlets  of  popular  character  which 
were  distributed  in  editions  of  over  a  hundred  thousand. 
There  was  in  existence  at  the  outbreak  of  the  war  an 
excellent  monthly  journal  on  work  for  cripples,  and  this 
devoted  its  columns  to  the  subject  of  provision  for  the 
war  disabled.  Some  other  special  publications  in  the 
same  field  immediately  sprang  up.  One  of  these  has 
the  interesting  title  of  "From  War  to  Industry." 

There  has  been  issued  under  the  title  of  "The  Will 
Prevails"  a  volume  of  biographies  of  cripples  who  have 
overcome  their  handicaps — from  Tamburlaine  down  to 
men  disabled  in  the  present  war.  The  book  is  intended 
for  circulation  in  hospitals  and  for  general  reading. 
Exhibitions  illustrating  in  a  practical  way  the  possibili- 
ties of  the  war  cripple  constitute  another  vehicle  of 
public  education,  and  have  been  held  in  the  leading 
centers  of  the  empire.  Moving  pictures  and  lantern 
slides  are  also  being  utilized  for  propaganda  to  stimulate 
interest  on  the  part  of  the  people  and  to  arouse  ambition 
and  courage  on  the  part  of  the  disabled  themselves. 

In  Canada  a  real  and  very  intelligent  effort  has  been 
made  to  acquaint  the  people  with  the  aim  and  practice 
of  re-education.  A  well-known  poster,  printed  in  red 
and    black,    entitled  "What    Every    Disabled    Soldier 


HELP      OR      HINDRANCE  107 

Should  Know"  is  widely  in  evidence  throughout  the 
Dominion.  It  is  really  addressed  as  much  to  the  public 
as  to  the  returned  soldier.  The  text  of  the  poster  is  as 
follows : 

That  there  is  no  such  word  as  "impossible"  in  his  dictionary. 

That  his  natural  ambition  to  earn  a  good  living  can  be  ful- 
filled. 

That  he  can  either  get  rid  of  his  disability  or  acquire  a  new 
ability  to  offset  it. 

That  the  whole  object  of  doctors,  nurses^  and  instructors  is 
to  help  him  in  doing  that  very  thing. 

That  he  must  help  them  to  help  him. 

That  he  will  have  the  most  careful  and  effectual  treatment 
known  to  science. 

That  interesting  and  useful  occupations  form  a  most  valuable 
part  of  the  treatment  in  the  convalescent  homes  and  san- 
atoria. 

That  if  he  cannot  carry  out  his  first  duty  by  rejoining  his 
comrades  at  the  front,  and  if  there  is  no  light  duty  for  him  with 
the  Canadian  forces  overseas,  he  is  taken  home  to  Canada,  as 
soon  as  his  condition  and  the  shipping  facilities  make  this 
possible. 

That  his  strength  and  earning  capacity  will  be  restored  there 
to  the  highest  degree  possible,  through  the  Invalided  Soldiers' 
Commission. 

That  if  he  requires  an  artificial  limb  or  kindred  appliance  it 
will  be  supplied  free. 

That  every  man  disabled  by  service  will  receive  a  pension  or 
gratuity  in  proportion  to  his  disability. 

That  if  his  disability  prevents  him  from  returning  to  his  old 
work  he  will  receive  free  training  for  a  new  occupation. 

That  full  consideration  is  given  to  his  own  capacity  and  de- 
sires when  a  new  occupation  has  to  be  chosen. 

That  his  own  will-power  and  determination  will  enable  him 
to  succeed,  both  in  tlic  training  and  in  the  occupation  afterwards. 


108  THE      DISABLED      SOLDIER 

That  his  maintenance  and  that  of  his  family  will  be  paid  for 
during  the  training  he  may  receive  after  discharge,  and  for  a 
month  longer. 

That  neither  his  treatment  nor  his  training  will  cost  him  a 
cent. 

That  his  home  Province  has  a  special  commission  to  assist 
him  in  finding  employment  on  discharge. 

That  hundreds  of  towns  and  villages  have  committees,  asso- 
ciations, and  clubs,  to  welcome  him  on  arrival,  and  to  help  in 
securing  a  position  for  him. 

That  the  Dominion  and  Provincial  governments,  the  munici- 
pal authorities,  and  all  sorts  of  employers,  give  the  returned 
soldier  preference  in  filling  vacant  positions. 

That  the  returned  soldier  wishing  to  take  up  land  and  farm 
it,  will  be  helped  to  do  so,  under  Federal  and  other  settlement 
schemes. 

That  the  Invalided  Soldiers'  Commission  exists  to  carry  out 
his  restoration  and  training  in  Canada. 

That  the  Board  of  Pension  Commissioners  exists  to  distribute 
the  pensions  provided  by  his  country  for  him  and  his  dependents. 

That  the  Invalided  Soldiers'  Commission  and  the  Board  of 
Pensions  Commissioners  are  in  the  position  of  trustees,  appointed 
for  his  benefit,  and  representing  the  whole  people  of  Canada, 

That,  therefore,  he  should  write  direct  to  the  commission  or 
the  board  if  he  needs  advice  or  help. 

Canadians  are  unanimously  resolved  that  every  returned  soldier 
shall  have  a  full  opportunity  to  succeed.  When  that  opportunity 
is  put  within  his  reach,  his  success  will  depend  on  his  own  good 
sense  in  seizing  and  using  it. 

Another  poster  of  pictorial  character  shows  a  one- 
armed  man,  fitted  with  an  artificial  appliance,  at  work 
on  a  drill  press. 

The  daily  press  has  been  supplied  with  material 
descriptive  of  the  success  of  men  who  have  completed 
training  and  made  good.     Some  stories  have  carried 


HELP      OR      HINDRANCE  109 

with  them  a  little  preachment  as  to  sound  attitude 
toward  the  disabled  soldiers.  One  concludes  with  this 
statement:  "Every  man  doing  steady  work  suited  to 
his  capacity  is  a  gain  to  himself  and  his  country.  Every 
man  left  idle,  or  performing  some  trifling  task  beneath 
his  capacity,  or  trying  to  do  work  he  is  unfit  for,  is 
wasted.    And  Canada  cannot  afford  to  waste  a  man." 

A  remarkable  moving  picture  film  in  ten  reels  has  been 
prepared  by  the  government  authorities  to  illustrate  the 
progress  of  the  disabled  soldier  after  his  return  from 
overseas.  It  shows  reception  at  the  debarkation  depot, 
transportation  in  a  hospital  train,  various  forms  of  treat- 
ment at  military  hospitals,  recreation,  vocational  train- 
ing, and,  finally,  re-employment  in  industry.  The  mes- 
sage of  the  series  of  reels  is  "that  injury  does  not  mean 
pauperism;  that  every  man  is  given  a  chance  to  make 
good."  Where  the  man  does  not  try  to  help  himself, 
however,  there  is  shown  the  opposite  eventuality  of 
vagrancy.  The  film  is  for  exhibition  in  Canadian  mili- 
tary hospitals  in  England,  and  for  showing  to  the  public 
of  the  Dominion. 

In  the  United  States  there  has  been  as  keen  if  not  a 
keener  realization  of  the  fundamental  importance  of 
public  education  to  the  cause  of  the  disabled  as  in  any 
other  country,  and  as  might  properly  be  expected  actual 
work  on  such  a  campaign  began  at  an  early  date.  The 
Surgeon  General  of  the  Army  issued  in  October,  1917, 
a  clear  statement  of  the  modern  policy  and  spirit  of 
dealing  with  the  disabled  soldier,  under  the  title  of  "The 
Passing  of  the  Cripple."  Later  the  same  office  made  an 
excellent  contribution  to  the  cause  in  the  preparation  of 
moving  picture  films  of  five  successful  American  cripples, 
who  were  seriously  handicapped,  yet  had  overcome  their 


110  THE      DISABLED      SOLDIER 

obstacles.  This  series  of  reels  was  entitled  "The  Way 
Out,"  and  was  intended  for  showing  to  the  general  public 
and  in  hospitals  overseas  to  men  who  have  just  met  with 
disabling  injury.  The  set  is  one  item  in  a  "cheer-up 
campaign,"  another  projected  feature  of  which  is  the 
issue  of  a  volume  of  biographies  of  disabled  Americans 
who  have  beaten  their  handicaps.  Still  another  factor 
in  this  work  is  the  issue  by  the  Surgeon  General,  in  co- 
operation with  the  American  Red  Cross  of  an  inspiration 
magazine,  by  name  "Carry  On,"  which  aims  to  convey  to 
members  of  the  Army  medical  corps,  to  Army  nurses,  to 
Red  Cross  home  service  workers,  and  to  the  public  at 
large  some  conception  of  the  new  spirit  in  dealing  with 
wounds,  of  more  kinds  than  one,  which  are  sustained  at 
the  front.  This  magazine  has  already  a  monthly  circu- 
lation of  over  a  hundred  thousand. 

An  unofficial  campaign  in  the  interest  of  the  disabled 
was  early  initiated  by  the  Red  Cross  Institute  for  Crip- 
pled and  Disabled  Men.  One  of  the  most  familiar  items 
in  this  campaign  was  a  small  folder  of  which  over  seven 
million  copies  were  distributed,  largely  through  the  cour- 
tesy of  telephone,  gas,  electric,  and  other  public  service 
corporations.  It  was  entitled  "Your  Duty  to  the  War 
Cripple"  and  its  text — which  epitomizes  the  gospel 
preached  in  the  campaign — read  as  follows: 

When  the  crippled  soldier  returns  from  the  front,  the  govern- 
ment will  provide  for  him,  in  addition  to  medical  care,  special 
training  for  self-support. 

But  whether  this  will  really  put  him  back  on  his  feet  depends 
on  what  the  public  does  to  help  or  hinder,  on  whether  the  com- 
munity morally  backs  up  the  national  program  to  put  the  dis- 
abled soldier  beyond  the  need  of  charity. 

In  the  past,  the  attitude  of  the  public  has  been  a  greater 
handicap  to  the  cripple  than  his  physical  disability.     People 


HELP      OR      HINDRANCE  111 

have  assumed  him  to  be  helpless,  and  have,  only  too  often,  per- 
suaded him  to  become  so. 

For  the  disabled  soldier  there  has  been  "hero-worship";  for 
the  civilian  cripple  there  has  been  a  futile  kind  of  sympathy. 
Both  do  a  man  more  harm  than  good. 

All  the  cripple  needs  is  the  kind  of  job  he  is  fitted  for,  and 
training  in  preparation  for  it.  There  are  hundreds  of  seriously 
crippled  men  now  holding  down  jobs  of  importance.  Other 
cripples  can  do  likewise,  if  given  the  chance. 

In  the  light  of  results  already  attained  abroad  in  the  training 
of  disabled  soldiers,  the  complete  elimination  of  the  dependent 
cripple  has  become  a  constructive  and  inspiring  possibility. 

Idleness  is  the  great  calamity.  Your  service  to  the  crippled 
man,  therefore,  is  to  find  for  him  a  good  busy  job,  and  encourage 
him  to  tackle  it. 

Demand  of  the  cripple  that  he  get  back  in  the  work  of  the 
world,  and  you  will  find  him  only  too  ready  to  do  so. 

For  the  cripple  who  is  occupied  is,  in  truth,  no  longer  handi- 
capped. 

Can  the  crippled  soldier — or  the  industrial  cripple  as  well — 
count  on  you  as  a  true  and  sensible  friend? 

The  assistance  of  chambers  of  commerce  and  manu- 
facturers' associations  was  enlisted  to  secure  transmittal 
to  their  members,  with  a  special  note  of  endorsement  by 
the  organization,  of  a  circular  calling  to  the  attention 
of  employers  their  responsibility  to  the  disabled  soldier. 
Over  two  hundred  thousand  employers  were  reached 
direct  in  this  manner,  and  the  statement  was  reprinted 
in  scores  of  trade  journals. 

A  speaker's  bureau  was  organized,  a  film  and  picture 
service  instituted,  and  the  daily  press  and  magazines  were 
supplied  with  informative  articles  on  the  work  being 
accomplished  abroad  in  the  reconstruction  of  crippled 
men.    One  of  the  most  interesting  features  of  the  work 


112  THE      DISABLED      SOLDIER 

was  the  preparation  for  individual  trade  journals  of 
articles  on  re-education  in  the  particular  trade  covered 
by  each  journal  or  on  employment  opportunities  for 
the  disabled  in  that  trade.  This  material  proved  of  very 
direct  interest  to  both  editors  and  readers  of  the  journals. 

Another  feature  of  the  campaign  was  the  issue  of  a 
booklet  in  ten  foreign  languages:  Yiddish,  French, 
Italian,  German,  Hungarian,  Polish,  Greek,  Spanish, 
Danish,  and  Swedish.  These  were  distributed  to  pastors 
of  foreign  language  speaking  congregations,  and  to  phy- 
sicians and  social  workers  in  the  foreign  communities. 
The  text  of  the  booklets  was  also  reprinted  by  almost 
every  foreign  language  newspaper  in  the  country. 

The  work  of  public  education  in  the  interest  of  the 
cripple  has  just  begun.  It  must  be  continued  until  the 
"man  on  the  street"  is  thoroughly  familiar  with  his 
responsibilities  to  the  disabled. 


HORS      DE      COMBAT  113 


CHAPTER  VIII 

HORS  DE  COMBAT 

The  disabilities  of  modern  warfare  are  varied  indeed. 
While  the  soldier  with  a  leg  off  has  represented  in  liter- 
ature and  illustration  the  war  disabled,  this  represen- 
tation is  statistically  far  from  accurate,  and  many  other 
classes  of  handicap  incurred  in  military  service  have 
numerically  exceeded  the  amputated.  Yet  to  the  public 
at  large  the  one-legged  hero  will  doubtless  continue  to 
typify  the  toll  of  warfare  in  disability. 

By  criteria  of  method  and  manner  of  treatment  and 
training,  certain  groups  of  the  disabled  are  set  aside  into 
classes  from  among  the  multitudinous  list  of  causes  for 
which  men  are  discharged  from  the  army.  Into  such 
clear  classifications  fall  the  blinded,  the  deafened,  the  shell 
shocked  and  other  mental  cases,  and  the  tuberculous. 
These  groups  will  be  dealt  with  in  succeeding  chapters. 
Excepting  cases  of  facial  disfigurement,  which  is  a  subject 
in  itself,  there  remain  to  be  considered  a  wide  variety  of 
cases  which  can  best  be  described  as  crippled,  allowing 
for  a  liberal  interpretation  of  that  term. 

This  class  comprises  amputations,  paralyses,  severe 
rheumatism,  limitation  of  movement  in  joints  due  to 
gunshot  injuries,  general  debility  due  to  long-contin- 
ued suppuration,  and  a  long  list  of  other  difficulties. 
Although  medical  treatment  may  vary,  all  may  be  con- 
sidered to  require  the  same  type  training  provision  and 
employment. 


114  THE      DISABLED      SOLDIER 

It  should  particularly  be  noted  that  many  of  the  most 
serious  disabilities  from  the  point  of  view  of  employment 
are  not  at  first  glance  apparent.  For  example,  a  tour 
may  be  made  of  some  Canadian  centers  of  re-education 
without  observing  in  the  classes  more  than  one  or  two 
obvious  cripples. 

It  is  the  crippled  soldiers  who  will  be  discussed  in  the 
present  chapter.  For  convenience  the  class  will  be  still 
further  sub-divided  into  amputation  cases  and  other  dis- 
abilities. 

The  first  requirement  of  the  amputation  case  is  an 
artificial  limb.  It  is  worthy  of  note  that  there  has  been 
a  complete  revolution  in  the  surgical  methods  in  leg 
amputations.  No  longer  is  a  crippled  man  permitted  to 
drag  himself  around  for  months  on  crutches,  learning 
how  to  walk  on  his  armpits-  and  forgetting  how  to  walk 
with  his  legs.  One  reason  for  this  practice  in  the  past 
was  that  it  was  impossible  to  fit  the  artificial  limb  until 
the  stump  had  had  a  chance  to  shrink  to  something 
resembling  its  final  form.  But  in  the  modern  anxiety  of 
the  surgeons  to  get  the  man  back  on  his  legs,  they  do  not 
w^ait  for  fitting  of  the  permanent  limb,  but  put  on  him 
at  once,  a  few  weeks  after  amputation,  a  temporary  peg 
leg  made  of  splints  and  plaster,  or  papier-mache,  or  of 
some  other  similar  material.  The  soldier  then  leaves  his 
bed  and  takes  his  first  steps  about  the  hospital.  An 
appliance  of  the  sort  meets  in  a  most  satisfactory  way 
all  the  requirements  of  transport  from  overseas. 

A  peg  leg  of  any  kind,  however,  if  worn  for  some  length 
of  time  gets  a  man  in  a  bad  habit  of  walking,  for  the 
reason  that  it  must  be  swung  outward  in  a  semi-circular 
motion  to  bring  the  foot  of  the  peg  from  the  end  of  one 
step  to  the  beginning  of  the  next.    This  process  is  known 


Learning  to  Walk  for  the  Second  Time. 
Italy,  crippled  soldiers  are  provided  with 
artificial  limbs  and  taught  to  use  them 


At  Naples, 


A  "Working  Arm"  in  lieu  of  Nature's  Own.     A  variety  of  tools 
can  be  fitted  into  the  chuck  of  this  appliance,  and  the  one- 
armed  poilu  is  again  enrolled  in  the  army  of  labor 


HORS      DE      COMBAT  115 

scientifically  as  abduction.  In  providing  for  leg  ampu- 
tations among  men  in  the  American  Expeditionary  Force, 
after  the  cases  have  been  returned  to  this  country, 
another  improvement  has  therefore  been  made.  Tem- 
porary limbs  of  hollow  fiber,  made  with  knee  and  ankle 
joints  in  practically  the  same  manner  as  the  final  leg, 
are  made  up  in  standard  units  in  sufficient  numbers  to 
meet  the  probable  demand.  These  are  fitted  to  the  men 
after  they  have  worn  the  peg  leg  for  a  short  time,  and 
the  fitting  can  be  changed  as  the  stump  alters  in  shape 
or  size.  This  provisional  leg  is  expected  to  last  from 
six  months  to  a  year  and  to  serve  satisfactorily,  therefore, 
until  the  permanent  limb  can  be  fitted  with  the  best 
results. 

France  and  Great  Britain  were  caught  unprepared  by 
the  demand  for  limbs,  as  their  supply  had  been  before 
the  war  largely  imported  from  Germany.  They  have 
had  to  make  strenuous  efforts  to  meet  their  needs. 

Most  of  the  countries  purchase  their  limbs  from  private 
manufacturers.  At  Roehampton,  the  great  limb-fitting 
center  in  England,  individual  manufacturers  have  been 
permitted  to  erect  shops  on  the  grounds  of  the  hospital. 
Canada  led  the  way  in  the  establishment  of  a  government 
limb  factory,  though  many  of  the  parts  used  were, 
during  the  first  year  or  two  of  operation,  purchased  from 
outside  concerns.  More  recently  Australia  has  estab- 
lished an  artificial  limb  shop,  which  is  now  operated  by 
the  Minister  of  Defense,  but  is  to  be  handed  over  at  the 
conclusion  of  the  war  to  the  Repatriation  Ministry.  In 
the  United  States  the  purchase  of  permanent  artificial 
limbs,  which  will  be  furnished  free  of  charge  to  crippled 
soldiers,  is  in  the  hands  of  the  Bureau  of  War  Risk 
Insurance, 


116  THE      DISABLED      SOLDIER 

The  most  popular  type  of  limb  being  made  abroad  is 
what  is  known  as  the  "American  leg."  This  is  made  up 
from  units  of  willow,  first  shaped  for  outside  contour  and 
then  hollowed  out  in  similar  contour  to  reduce  weight. 
The  units  are  then  covered  with  rawhide,  varnished,  and 
assembled  with  the  joints,  stops,  and  springs  necessary 
to  their  proper  functioning. 

In  the  field  of  artificial  arms  an  American  model  has 
again  had  preference,  though  a  very  satisfactory  but 
elaborate  type  has  recently  been  worked  out  in  France. 
These  arms  permit  the  performance  of  practically  all  the 
duties  of  every  day  life. 

In  arms  of  this  character  movement  is  attained  by 
linking  up  the  mechanism  by  cables  of  wire  or  rawhide 
with  new  muscular  combinations.  Thus  expiration  of 
the  chest  may  open  the  fingers,  and  movement  of  the 
opposite  shoulder  may  operate  the  elbow. 

A  still  more  modern  development,  the  invention  of  an 
Italian  surgeon  by  name  Vanghetti,  is  what  is  known  as 
kinematic  amputation.  By  this  method  of  operation 
tendons  and  muscles  are  so  arranged  that  attachment 
may  be  made  to  them,  and  there  may  thus  be  caused 
direct  movement  of  the  artificial  member.  Very  often, 
however,  the  action  of  a  muscle  will  cause  a  different 
movement  from  that  which  it  was  accustomed  to  effect 
under  natural  conditions,  and  it  then  becomes  necessary 
to  re-educate  the  motor  reactions  in  order  to  attain 
ordered  control.  The  final  value  of  this  method  has 
not  yet  been  determined. 

One  of  the  most  interesting  developments  in  dealing 
with  cases  of  arm  amputation  is  the  fitting  of  industrial 
workers  with  mechanical  appliances,  designed  to  meet 
the  requirements  of  their  particular  trades.     Thus  a 


HORS      DE      COMBAT  117 

bench  machinist  will  be  provided  with  a  chuck  which  will 
hold  interchangeably  a  file,  hammer,  chisel,  or  other  tools. 
A  drill  press  operator  will  have  a  hook  or  ring  which  will 
pull  down  the  lever  of  his  machine.  An  agricultural 
worker  will  be  equipped  with  a  cylindrical  grip  or  grips 
which  will  slip  over  and  hold  the  handles  of  various  farm 
tools.  A  glass  worker  will  have  an  appliance  especially 
suited  to  the  demands  of  that  calling.  Such  apparatus 
do  not  displace  the  modern  artificial  arm  which  is  also 
furnished  to  the  arm  cripple  to  use  in  his  home  on  even- 
ings and  Sundays.  But  it  has  been  thought  wise  for 
specialized  jobs  to  develop  specialized  appliances  to 
perform  them. 

Especial  ingenuity  has  been  devoted  in  France  to  the 
design  of  apparatus  for  agricultural  workers  in  order  to 
assist  the  effort  to  put  back  on  the  land  just  as  many 
men  as  possible  whose  experience  has  been  in  farming. 
Even  men  with  both  arms  amputated  have  been  refit- 
ted for  this  work. 

There  are  other  arm  devices  for  general  use  which  do 
not  resemble  arms.  One  is  a  universal  hook  which  will 
perform  a  wide  variety  of  tasks.  Another,  invented  and 
developed  by  a  man  who  is  himself  handicapped  by 
double  arm  amputation,  consists  of  a  holder  in  which  is 
a  general  utility  hook  which  may  be  replaced  by  knife, 
fork,  pen,  or  other  tool  or  implement.  This  is  one  of  the 
most  practical  appliances  for  a  man  with  both  arms 
off. 

While  many  of  the  most  eminent  engineers  and  ortho- 
pedic surgeons  of  Germany  were  engaged  in  the  devel- 
opment of  working  arms  for  industrial  or  agricultural 
employees,  the  best  and  most  practical  model  of  all  was 
produced  by  a  simple  peasant  who  had  lost  one  of  his 


118  THE      DISABLED      SOLDIER 

own  arms  in  the  war.  The  arm  is  named  after  him  the 
"Keller  Claw." 

For  partial  paralyses  and  other  orthopedic  difficulties 
not  involving  amputation  all  kinds  of  supports,  braces, 
and  the  like,  of  great  ingenuity  and  in  wide  variety,  have 
been  devised. 

The  cases  of  crippling  disability  other  than  amputation 
require  little  comment  in  a  book  of  this  character,  for 
they  are  treated  according  to  standard  methods  of  medi- 
cine and  surgery.  The  most  interesting  new  development 
is  the  advance  in  methods  of  "functional  re-education  "as 
it  is  called — the  training  of  injured  joints,  muscles,  and 
the  like  back  to  normal  movement  and  capacity.  This 
treatment  is  now  active  rather  than  passive,  that  is,  the 
patient  exercises  himself  rather  than  sits  quiescent  with 
the  movement  induced  by  external  force.  In  one  set  of 
most  interesting  apparatus  there  is  a  dial  on  every  piece 
so  that  the  patient  can  see  for  himself  what  range  of 
movement  is  attained  and,  as  it  were,  compete  with  his 
own  record  at  the  preceding  treatment. 

As  regards  trades  suitable  for  cases  of  arm  and  leg 
amputation,  there  is  accurately  speaking  no  such  classi- 
fication possible,  because  the  future  of  each  man  must 
be  determined  by  individual  considerations.  A  trade 
which  might  be  unwise  for  the  great  majority  of  arm 
cases  might  in  an  individual  instance,  by  reason  of  the 
man's  past  experience,  be  the  best  one  for  him  to  under- 
take. There  can  be  made  a  list  of  trades  not  possible  to 
the  amputated  of  various  types,  but  the  converse  cannot 
so  confidently  be  compiled. 

An  approximation  based  on  experience  in  re-educating 
arm  or  leg  cripples  can,  however,  be  arrived  at.  Such  is 
represented  by  a  list  issued  by  the  British  Ministry  of 


HORS      DE      COMBAT  119 

Pensions.  For  leg  amputations,  among  others,  it  lists: 
bootmaking,  caretaker,  chauffeur,  domestic  service,  elec- 
trical work,  engineering,  gateman,  groom,  hall  porter, 
hospital  orderly,  industrial  work  (sundry  forms),  muni- 
tion work,  milker,  packer,  painter,  printing,  railway  work 
(varied),  tailoring,  telephone  attendant,  telegraphy,  time- 
keeper, and  watchman.  For  arm  amputations  it  lists: 
clerical  work,  gymnastic  instructor,  messenger,  porter, 
railway  work  (sundry  duties),  scholastic,  telephone 
switchboard  attendant,  timekeeper,  watchman. 

A  few  generalizations  apply.  A  man  with  an  artificial 
leg  should  not  be  prepared  for  a  job  which  will  keep  him 
standing  or  walking  more  than  one-third  or  one-half  the 
time.  A  one-armed  man,  if  his  mental  capacity  permits, 
may  most  successfully  be  trained  for  a  clerical  or  desk  job. 

In  the  actual  work  with  cripples  there  is  no  limit  on 
originality,  for  each  case  practically  entails  a  new  eco- 
nomic plan.  The  worker  in  this  field  will  discover  new 
principles  as  he  proceeds.  There  is  also  no  limit  to  the 
fascination  of  the  subject,  for  the  field  is  still  a  frontier 
for  pioneers  and  the  satisfaction  derived  from  putting  one 
helpless  man  after  another  back  on  his  feet  is  very  real 
indeed. 


120  THE      DISABLED      SOLDIER 

CHAPTER  IX 

OUT  OF  THE  DARKNESS 

Blindness  is  a  very  serious  handicap,  the  intensity  of 
which  cannot  be  minimized.  This  is  especially  the  case 
with  the  loss  of  sight  occurring  in  adult  life  as  with  the 
blinded  soldier.  With  all  his  activities  organized  on  a 
sighted  basis,  the  new  limitation  seems  crushing.  Yet 
there  is  a  way  out  of  the  darkness  to  happiness,  and  it  is 
our  sacred  duty  to  help  the  blind  veteran  to  find  that  road. 

This  obligation  has  been  well  stated  by  Eugene  Brieux, 
who  has  taken  a  deep  interest  in  the  war  blinded  of 
France.  "For  some  wounded  soldiers  our  responsibility 
is  over  when  their  wounds  are  healed,  but  for  the  blind 
it  then  only  begins.  Blinded  soldiers  have  been  reduced 
to  a  state  of  disadvantage  to  other  men;  they  have 
become  again  children,  before  whom  stretches  the  possi- 
bility of  a  happy  life,  but  who  must  be  initiated  into  this 
new  life.  They  have  need  of  treatment  other  than  physi- 
cians can  give,  of  other  aid  than  consolation  and  kind- 
ness. They  need  to  be  prepared  for  their  new  life — to 
be  armed  for  the  struggle  upon  which  they  are  entering. 
It  is  true  that  they  enter  the  struggle  less  enfeebled  than 
one  would  think,  far  less  than  they  themselves  believe, 
but  their  capacities  are  of  a  different  kind  from  what 
they  were  before,  and  the  period  of  adaptation  is  hard." 
During  this  period,  those  privileged  to  care  for  the  blinded 
soldier  will  need  all  the  tact  and  skill  at  their  command. 

Fortunately,  the  number  of  soldiers  suflfering  from  loss 
of  sight,  total  or  approximately  so,  is  comparatively 


OUT      OF      THE      DARKNESS  121 

small.  According  to  British  statistics  injuries  to  sight 
account  for  but  two  and  eight-tenths  per  cent,  of  the 
disability  pensions  granted.  In  the  Canadian  forces  up 
to  date  there  have  been  blinded  less  than  one  hundred 
men. 

In  starting  in  with  the  blinded  soldier  there  are  two 
primary  requirements.  The  first  is  to  overcome  the 
deep  discouragement  in  which  the  man  is  likely  to  be 
plunged.  The  second  is  to  teach  the  soldier  to  be  blind 
— how  to  accomplish  the  little  everyday  tasks  which 
make  life  possible  and  comfortable.  The  first  of  these 
goes  with  the  latter,  for  as  the  man  learns  how  to  take 
care  of  himself  and  get  about  with  some  facility,  hope 
begins  to  return.  In  these  early  stages  another  blind 
man  is  the  best  teacher,  and  will  succeed  where  the 
sighted  fail.  Sometimes  a  fellow  warrior  who  has  him- 
self been  blinded,  but  has  already  had  his  start,  will  be 
most  effective  of  all.  The  first  blinded  American  sailor 
who  returned  to  our  training  center  at  Baltimore  was 
so  far  depressed  that  his  case  seemed  hopeless.  Nothing 
could  be  done  with  him  until  there  was  put  on  the  job 
the  first  blinded  American  soldier,  who  had  an  earlier 
start  and  had  already  "seen  the  light."  His  companion- 
ship and  encouragement  turned  the  trick,  and  of  course 
the  advantage  was  reciprocal. 

All  along  the  course  of  re-education  the  blind  can  be 
of  the  greatest  assistance  to  the  sightless  soldiers.  They 
make  good  teachers  for,  when  they  argue  that  a  thing 
can  be  done,  it  is  likely  to  carry  conviction.  They  know 
whereof  they  speak. 

Another  necessity  is  teaching  the  families  to  have  a 
blind  member,  and  be  helpful  to  him  rather  than  the 
reverse.    The  American  program  for  re-educating  blinded 


122  THE      DISABLED      SOLDIER 

soldiers  provides  for  bringing  the  families  of  the  men  to 
the  training  school  for  a  visit,  so  that  they  may  become 
acquainted  with  and  understand  the  methods  by  which 
the  men  are  led  to  be  independent.  If  when  the  man 
returns  home  the  family  immediately  discourages  his 
ever  moving  out  of  his  chair,  insists  that  he  will 
stumble  if  he  walks  about  the  house,  and  brings 
everything  to  him,  they  will  be  destroying  the  good 
accomplished  during  his  training.  It  has  been  well 
said  that  "they  should  not  place  him  in  a  corner  out  of 
reach  of  all  danger  like  a  feeble  old  man  or  a  child  in 
swaddling  clothes."  They  must  rather  tactfully  encour- 
age him  to  do  more  and  more  for  himself  and  urge  him 
to  get  up  and  about.  They  must  be  prepared,  in  a  word, 
to  continue  his  re-education. 

Blinded  soldiers  must  be  protected  during  their  period 
of  training  against  the  visits  of  curious  but  well-meaning 
people,  whose  ill-advised  remarks  will  do  more  harm  in 
a  few  minutes  than  the  benefit  which  a  teacher  will 
impart  in  as  many  days.  Several  French  schools  have 
prominently  displayed  this  notice:  "To  pity  is  not  to 
console!  Only  words  of  hope  and  confidence  should  be 
spoken  here." 

Recreation  is  an  important  factor  in  the  social  treat- 
ment of  the  blinded  soldier.  One  of  the  primary  methods 
of  entertainment — ^with  instruction  combined — is  reading 
aloud  to  a  group  of  men.  At  one  of  the  oldest  schools 
for  the  blind  in  Paris  a  daily  newspaper  is  read  from  each 
morning,  the  choice  of  the  journal  being  determined  by 
vote  of  the  auditors.  Music  is  another  means,  and  the 
blind  should  be  encouraged  to  take  part  in  group  singing. 
Many  athletic  games  of  considerable  vigor  are  entirely 


OUT     OF      THE      DARKNESS 123 

within  the  reach  of  the  blind,  and  almost  any  form  of 
gymnastic  work  is  practical. 

For  inside  recreation  there  are  playing  cards  with 
raised  symbols  of  identification,  dominoes  with  the  dots 
raised  instead  of  sunk,  and  sets  of  checkers  with  the 
black  pieces  square  and  the  red  pieces  round. 

The  first  educational  necessity  for  the  blinded  soldier 
is  the  learning  of  Braille.  Fortunately,  in  this  country 
and  Great  Britain  the  divergences  of  opinion  which  were 
responsible  for  the  existence  of  several  different  alphabets 
have  been  reconciled  and  there  has  now  been  adopted  a 
standard  type.  Learning  this  the  blind  man  will  be 
enabled  to  continue  his  reading  or  study  to  keep  posted 
on  current  developments  through  a  monthly  magazine 
in  raised  letters,  and  correspond  with  his  friends.  He 
may  write  himself  either  in  embossed  print  or  with  the 
aid  of  a  guide  to  keep  the  lines  straight  and  regular,  with 
pencil  or  pen.  He  should  be  encouraged  to  do  the  latter  so 
that  he  may  not  forget  how.  With  men  who  were  illit- 
erate before  they  became  blind  the  matter  of  teaching 
them  to  read  and  write  Braille  is  not  so  important. 

In  the  past  the  blind,  like  the  crippled,  have  suffered 
from  the  conception  that  the  only  occupations  within 
their  capabilities  were  those  of  basket-making,  chair- 
caning,  and  other  similar  handicrafts.  Almost  no  schools 
had  attempted  teaching  the  more  highly  skilled  special- 
ties. Yet  the  few  experiments  which  have  been  attempted, 
and  the  instances  where  ambitious  blind  men  have  made 
places  for  themselves,  show  that  well-paid  occupations 
are  not  closed  to  the  sightless.  A  few  examples  will  show 
the  manner  in  which  the  problem  is  approached. 

In  a  large  factory  making  an  ignition  and  lighting 
system  for  automobiles,  much  expert  assembly  work  is 


124  THE      DISABLED      SOLDIER 

performed  by  a  man  totally  blind.  Is  this  man,  who 
does  all  his  work  by  sense  of  touch,  under  any  handicap 
in  competition  with  his  sighted  colleagues?  As  a  matter 
of  fact,  he  is  probably  a  more  faithful  workman  because 
he  appreciates  the  opportunity  of  his  job,  and  is  likely 
to  turn  out  a  better  day's  product  than  the  man  next 
to  him  because  he  will  not  be  distracted  by  looking  out 
of  the  window  at  things  going  on  in  the  street. 

In  a  clock  factory  which  uses  as  gongs  spiral  coils  of 
tempered  wire  it  is  necessary  accurately  to  test  and 
adjust  the  tone  of  each  gong.  This  is  done  by  striking 
the  coil,  listening  to  the  result,  and  then  making  the 
necessary  change  by  a  screw  sleeve  at  one  end.  In  this 
job  which  requires  the  use  of  two  senses  only — touch  and 
hearing — is  a  blind  man  at  any  disadvantage  after  he 
has  acquired  skill  for  this  work? 

The  first  attempt  in  planning  occupations  for  the  blind 
is  to  send  them  back  to  their  former  trade,  if  this  is  in 
any  way  possible.  And  it  will  be  found  practicable  in  more 
instances  than  would  be  imagined.  In  actual  experience 
competent  blind  workmen  will  be  encountered  in  almost 
every  line  of  employment. 

Two  satisfactory  occupations  which  are  almost  tradi- 
tional to  the  blind  are  massage  and  piano  tuning.  Men 
who  have  been  trained  in  the  first  subject  have  gone 
back  to  employment  in  military  orthopedic  hospitals, 
where  their  patients  are  fellow-soldiers  injured  in  other 
ways  than  themselves.  The  period  of  training  is  fairly 
long  and  the  work  only  suited  to  men  with  certain  quali- 
fications, but  for  those  who  can  learn  to  be  good  masseurs, 
employment  is  secure  and  earnings  good.  In  Japan  the 
practice  of  massage  has  been  reserved  as  a  monopoly  for 
the  blind.    Piano  tuning  is  for  many  blind  men  an  ex- 


OUT      OF      THE      DARKNESS  125 

cellent  business,  but  it  is  a  crowded  field  and  care  must 
be  taken  not  to  train  for  it  too  many  novices. 

Men  employed  in  clerical  lines  before  the  onset  of 
blindness  can  be  trained,  with  the  aid  of  a  few  simple 
devices,  to  continue  their  office  job. 

Many  blind  soldiers  who  come  from  the  farms  can 
most  advantageously  return  to  the  same  work.  The  man 
without  sight  is  better  off  in  many  ways  in  the  country, 
where  he  can  get  around  with  little  difficulty,  without 
the  need  of  a  guide,  and  running  small  risk  of  accident. 
In  addition  the  national  interest  is  served  by  his  con- 
tinued activity  as  a  good  producer. 

It  may  appear  at  first  blush  that  a  blind  man  could 
not  get  on  at  all  in  work  about  a  farm.  But  note  the 
evidence  in  a  letter  from  a  blinded  French  soldier: 

A  man  used  to  working  on  the  farm  even  if  he  is  totally  blind 
can  do  practically  everything  around  the  barns  and  stables,  if 
he  is  not  lazy  or  stupid.  He  can  clean  up  the  yards,  go  for  water, 
rub  down  the  horses  and  cows,  and  feed  ail  the  animals.  It  is 
not  hard  to  recognize  with  your  hands  the  linseed  mash,  the 
barley,  and  the  bran  or  the  oats,  and  to  know  also  through  your 
hands  when  the  racks  and  mangers  are  full,  and,  when  you 
come  back  later,  to  tell  still  by  your  hands  whether  the  animals 
have  eaten.  You  do  not  need  to  see  to  tend  the  winnowing- 
machine,  to  help  in  putting  the  grain  into  sacks,  and  then  to 
put  the  sacks  in  the  wagon.  You  can  cut  up  beets  for  the  cows, 
too,  and  you  can  help  in  making  bread  for  the  family,  for  in 
our  part  of  the  country  bread  is  made  in  the  house. 

The  work  in  the  field  is  harder,  I  admit,  but  there  are  lots  of 
tasks  which  you  think  at  first  are  quite  impossible — you  would 
have  laughed  in  the  old  days  if  anyone  had  told  you  a  man  could 
do  them  without  seeing — but  which  now  after  three  or  four 
attempts,  after  three  or  four  failures  perhaps,  you  finally  accom- 
plish.   You  can  easily  dig  beets  and  potatoes,  unload  wagons. 


126  THE      DISABLED      SOLDIER 

and  in  the  season  thresh  and  spread  the  hay.  I  can't  mentioa 
everything,  of  course,  but  there  you  have  already  quite  a  list. 
In  addition,  when  it  rains  and  you  have  time  on  your  hands, 
you  can  make  brushes,  as  you  learned  to  do  in  the  hospital. 
I  should  never  have  believed  that  I  could  be  as  contented  as 
I  am  now. 

The  best  known  institution  in  the  world  for  blinded, 
soldiers  is  "St.  Dunstan's,"  in  Regent's  Park,  London. 
In  a  fine  old  house  set  in  the  midst  of  fifteen  acres  of 
beautiful  land,  are  housed  the  British  soldiers  who  have 
lost  their  sight  in  battle.  Its  "heart  and  soul"  is  Sir 
Arthur  Pearson,  who  lost  his  sight  several  years  ago  and 
who  has  devoted  his  life  to  the  task  of  "teaching  men  to 
be  blind,"  as  he  expresses  it. 

Shortly  after  the  war  began.  Sir  Arthur,  then  President 
of  the  National  Institute  for  the  Blind,  organized  the 
Blind  Soldiers'  and  Sailors'  Care  Committee,  which  set 
about  to  find  a  suitable  building  where  blinded  soldiers 
might  be  trained.  The  selection  was  St.  Dunstan's,  gen- 
erously placed  at  the  disposal  of  the  committee  by  Mr. 
Otto  H.  Kahn  who  had  the  lease  of  it  at  that  time.  The 
building  was  once  the  country  house  of  the  wicked  Lord 
Steyne  of  Thackeray's  "Vanity  Fair." 

On  March  26,  1915,  fourteen  blinded  soldiers  entered 
St.  Dunstan's  Hostel  to  start  on  the  journey  to  self- 
support  and  hope.  Three  years  later  St.  Dunstan's  and 
its  annexes  held  578  men,  after  having  graduated  434, 
of  which  number  ninety  per  cent,  had  been  fully  trained 
and  set  up  in  the  occupations  which  they  had  learned  in 
the  school. 

The  notable  feature  of  St.  Dunstan's  is  its  cheerful 
atmosphere.  After  the  men  have  surmounted  the  first 
few  days  of  depression  brought  on  by  the  thought  of 


OUT      OF      THE      DARKNESS  127 

"living  always  in  the  night,"  they  look  out  for  them- 
selves and  go  about  like  normal  men. 

The  blinded  guests  have  very  little  difficulty  in  getting 
about  at  St.  Dunstan's.  They  manage  to  find  their  way 
without  the  aid  of  a  stick  and  without  being  led  by  the 
hand.  This  they  are  enabled  to  do  by  a  unique  device. 
Strips  of  carpet  of  even  breadth  run  through  the  center 
of  every  room.  As  long  as  they  can  feel  the  carpet  under 
their  feet,  they  know  there  is  no  danger  of  their  running 
into  any  obstacle.  A  visitor  at  St.  Dunstan's  relates  that 
two  men  bumped  into  each  other  as  they  were  walking 
in  opposite  directions  on  the  same  strip,  but  exchanged 
greetings  merrily  and  continued  on  their  way  as  if 
nothing  had  happened. 

To  guide  the  men  when  they  go  about  out  of  doors, 
other  devices  have  been  arranged.  On  the  top  and 
bottom  steps  of  stairways,  wood  or  lead  strips  are  fas- 
tened to  tell  the  men  where  they  are.  Along  the  paths 
leading  to  the  various  outlying  buildings,  railings  are 
placed,  with  little  knobs  to  tell  the  men  when  they  come 
to  a  turn  in  the  road. 

There  are  amusements  such  as  rowing,  swimming, 
dancing,  indoor  games — such  as  dominoes,  checkers, 
chess,  and  cards;  they  have  a  debating  society,  and 
almost  every  man  learns  to  play  some  kind  of  musical 
instrument.  They  have  their  theatrical  clubs  and  last 
December  gave  an  excellent  performance  of  "Babfts  in 
the  Wood." 

But  it  is  not  all  play  at  St.  Dunstan's.  The  actual  re- 
education and  training  are  carried  on  in  either  classroom 
or  workshop.  Those  who  are  assigned  to  the  workshop 
in  the  morning  are  in  the  classroom  in  the  afternoon  and 
vice-versa.    The  working  day  is  from  9:30  to  12  in  the 


128  THE      DISABLED      SOLDIER 

morning,  from  2:30  to  4:30  in  the  afternoon,  with  an 
optional  extra  hour  for  those  who  wish  it. 

The  classroom  work  consists  largely  in  the  teaching 
of  Braille  and  typewriting.  The  men  are  taught  to  read 
and  write  Braille,  both  arts  very  difficult  to  acquire  and 
involving  considerable  strain  on  the  mental  faculties. 
To  relieve  this,  the  Braille  lessons  are  interspersed  with 
netting,  which  is  something  of  a  hobby,  at  which  a  man 
can  make  in  his  spare  time  five  or  six  shillings  a  week. 

All  the  men  are  taught  typewriting,  which  they  find 
enjoyable  and  at  which  they  usually  become  very  pro- 
ficient. 

Affiliated  to  this  classroom  work  are  three  occupations, 
the  successful  performance  of  which  requires  a  knowledge 
of  Braille  and  skill  in  the  use  of  the  typewriter.  These 
are  massage,  shorthand,  and  telephone  operating. 

To  learn  massage  demands  a  knowledge  of  Braille, 
because  many  of  the  requisite  books  on  anatomy  and 
physiology  have  been  put  into  raised  type.  Blinded 
men  have  been  trained  as  highly  skilled  masseurs  at 
St.  Dunstan's.  Shorthand  for  the  blind  is  a  system  of 
condensed  Braille,  and  is  written  by  means  of  a  special 
little  machine.  Telephone  operating  on  boards  operat- 
ing with  drop  signals  rather  than  lights  is  successfully 
taught. 

In  the  workshops  at  St.  Dunstan's  the  men  are  taught 
cobbling,  mat-making,  basket-making,  and  joinery. 
Most  of  the  instructors  are  blind  and  thus  furnish  an 
inspiring  example  for  the  pupils. 

On  a  spacious  poultry  farm,  beyond  the  workshops, 
men  are  taught  poultry  raising  on  modem  scientific  lines. 
They  learn  to  distinguish  by  touch  birds  of  various 
breeds,  to  manage  incubators  and   foster-mothers,  to 


OUT      OF     THE      DARKNESS  129 

prepare  and  truss  birds  for  table,  and  in  general  to 
conduct  a  paying  poultry  business.  The  pupils  are  also 
taught  rough  carpentry,  so  that  they  can  make  hen- 
coops, setting-boxes,  gates,  and  other  farm  essentials.  A 
post-graduate  course  in  poultry  farming,  so  to  speak,  is 
given  at  St.  Dunstan's  Poultry  Farm,  near  King's 
Langley,  and  is  a  month  in  duration. 

Wherever  possible  a  man  is  returned  to  his  former 
trade  or  occupation.  It  has  been  possible  for  men  to 
resume  their  employment  by  giving  them  special  courses 
of  instruction  or  by  teaching  them  special  methods. 
When  a  man  completes  his  training  at  St.  Dunstan's,  he 
is  settled  in  the  trade  that  he  has  studied,  is  equipped 
with  an  outfit  and  with  an  abundant  supply  of  raw 
material.  Through  a  carefully  organized  after-care  sys- 
tem, he  is  visited  regularly,  his  work  is  supervised,  raw 
material  is  supplied  to  him  at  cost,  and  he  is  assisted  in 
marketing  his  goods. 

Graduates  of  St.  Dunstan's  earn  a  fair  living  wage. 
It  must  be  remembered  that  the  blind  soldier  with  an 
earning  capacity  is  enabled  to  augment  his  pension  which 
is  not  affected  by  increase  of  income  as  his  skill  and 
earning  power  increases. 

In  France  at  the  beginning  of  1915,  when  it  became 
clear  that  the  number  of  blinded  soldiers  was  going  to 
be  considerable,  the  Ministry  of  the  Interior  created  a 
special  institution  for  them  in  an  old  building  in  the 
Rue  de  Reuilly,  Paris.  All  the  war  blind  were  to  be  sent 
there  when  their  medical  treatment  was  completed. 
Accommodations  were  provided  for  two  hundred  persons. 
The  first  group,  admitted  in  March,  1915,  consisted  of 
forty  men.  But  soon  the  home  was  filled  to  capacity, 
and  seventeen  branches  have  had  since  to  be  created: 


130  THE      DISABLED      SOLDIER 

three  in  Paris,  two  in  Lyons,  and  one  in  each  of  the 
following  cities:  Amiens,  Bayonne,  Bordeaux,  Caen, 
Chartres,  Dijon,  Marseilles,  Montpellier,  Nantes,  Saint- 
Brieuc,  Tours,  Toulouse. 

The  institution  is  under  the  control  of  the  Ministry  of 
the  Interior.  Since  its  creation,  however,  it  appeared  to 
the  director  that,  in  addition,  private  initiative  might 
be  advantageously  organized.  He  created  the  Society 
of  Friends  of  Blinded  Soldiers,  formed  of  representatives 
of  the  Ministries  of  the  Interior  and  of  War,  of  Parlia- 
ment, of  the  Quinze-Vingts  hospital  for  blind,  of  the 
teaching  profession,  of  commercial  circles,  and  of  the 
Catholic,  Protestant,  and  Jewish  interests.  It  was 
through  the  efforts  of  this  society  that  the  different  ac- 
tivities of  the  institution  have  developed. 

The  Reuilly  home  was  created  as  a  "Convalescent 
Home  for  Blinded  Soldiers,"  without  any  precise  idea 
as  to  what  it  was  to  do  for  its  inmates.  It  was  but 
gradually  and  empirically  that  the  re-education  work  has 
been  built  up.  One  month  after  the  inauguration  of  the 
home,  a  very  small  shop  for  brush-making  was  opened. 
The  experiment  was  successful,  and  the  brush-making 
shop  was  soon  overcrowded.  It  is  still  the  most  popular 
with  the  men.  Since  1915,  however,  the  re-education 
work  has  greatly  expanded  by  the  addition  of  new  trades. 

At  the  present  time,  there  are  taught  at  Reuilly  all 
the  standard  trades  for  the  blind — brush-making,  basket- 
making,  making  and  repairing  of  chairs,  and  so  on.  The 
course  of  massage,  which  has  been  a  marked  success, 
consists  of  two  sections:  massage  proper  and  theoretical 
instruction  in  anatomy  and  physiology.  The  latter  in- 
cludes a  complete  course  of  lectures  which  it  is  neces- 
sary to  write  in  Braille;  ability  to  read  by  touch  is  pre- 


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OUT      OF      THE      DARKNESS  131 

requisite.  At  the  end  of  the  course,  the  students  have 
to  pass  a  very  strict  examination  before  a  jury  of  physi- 
cians; they  are  never  discharged  before  receiving  their 
diploma.  Since  February,  1917,  a  group  of  graduates 
from  Reuilly  have  been  employed  as  masseurs  in  the 
military  hospitals  of  Paris,  and  have  given  great  satis- 
faction to  the  medical  authorities.  Others  have  found 
employment  at  the  different  resorts,  at  Monte  Carlo, 
Vichy,  Evian,  Deauville. 

A  shoe-repairing  shop  was  established  in  February, 
1916.  The  work  was  first  confined  to  pegged  shoes,  but 
later  an  invention  of  one  of  the  students  made  possible 
hand-sewn  work  also.  Several  men  have  graduated  and 
found  employment.  The  first  pupil  of  the  shoemaking 
school  is  now  employed  as  an  instructor  in  a  workshop 
for  blind  civilians. 

A  machine  shop,  under  the  direction  of  a  blind  in- 
structor, has  been  in  operation  for  two  years.  The  first 
twelve  pupils  are  now  working  in  a  special  shop  created 
for  war  blind.  This  shop  is  now  filling  orders  for  several 
of  the  largest  automobile  and  machine  plants. 

A  course  in  piano  tuning  has  been  started  on  the  ini- 
tiative of  a  prominent  piano  manufacturer,  himself  blind. 
Other  courses  are  in  crystal  grinding  and  telephone  oper- 
ating. Organ  playing  and  singing  are  taught,  not  as 
independent  vocations,  but  as  possible  supplementary 
occupatioHS  in  rural  localities.  Macrame,  rafifia,  and 
netting  are  not  considered  as  real  trades,  but  are  taught 
to  new  arrivals  for  distraction  and  as  a  first  preparatory 
exercise. 

As  a  general  rule,  all  the  men  learn  to  read  Braille. 
There  has  been  established  at  the  home  a  printing  shop 
in  which  books  in  Braille  are  produced.    To  interest  the 


132  THE      DISABLED      SOLDIER 

men  in  reading,  there  is  distributed  every  morning  the 
official  war  bulletin  printed  in  Braille.  Still  more  effec- 
tive in  stimulating  interest,  has  proved  the  publication 
of  the  "Reuilly-Midi,"  a  small  daily,  which  contains  all 
the  news  of  the  institution. 

Many  of  the  men  learn  typewriting,  although  it  is  not 
intended  to  train  them  for  positions  of  typists.  For  the 
use  of  those  who  wish  to  correspond  in  ordinary  hand- 
writing, the  administration  of  the  home  has  devised  a 
very  simple  "hand-guide,"  which  permits  the  blind  to 
write  on  equidistant  straight  lines. 

A  very  surprising  experiment,  which  has  given  excellent 
results,  is  a  course  in  fencing,  directed  by  an  expert 
teacher. 

In  Germany,  where  a  number  of  institutions  for  the 
training  of  blind  had  existed  before  the  war,  the  general 
policy  was  that  of  creating  in  these  institutions  special 
sections  for  blinded  soldiers.  One  of  the  most  important 
institutions  of  this  type  is  that  at  Breslau,  which  accom- 
modates about  fifty  men.  The  men  are  transferred  to  the 
school  after  their  medical  treatment  has  been  completed 
and  stay  there  for  about  three  months.  They  are  kept 
under  military  discipline,  and  the  training  is  compulsory. 
Many  of  the  men  remain  in  the  institution  voluntarily 
after  being  discharged  from  the  army;  in  that  case  they 
contribute,  out  of  their  pension,  for  their  maintenance 
one  mark  a  day. 

One  year  is  considered  as  the  average  length  of  time 
required  to  teach  a  blind  man  Braille  and  one  of  the 
standard  trades  for  blind,  such  as  basket-making,  brush- 
making,  rope-making,  and  the  like.  Of  these  occupa- 
tions, basket-making  of  the  rough  type  is  the  most 
popular  with  the  men,  especially  those  of  country  origin. 


OUT      OF      THE      DARKNESS  133 

Effort  is  often  made  to  return  the  man  to  his  former 
trade.  The  experience  has  been  successful  with  several 
men,  former  bakers,  cigar-makers,  watch-makers.  In 
addition  to  the  trades  taught  at  the  institution,  a  number 
of  men  have  been  placed  for  training  in  industries,  such 
as  munition  plants,  clothing  factories,  and  so  forth. 

In  connection  with  the  institution,  has  been  estab- 
lished an  agricultural  training  station,  intended  mainly 
for  peasants.  It  seems,  however,  that  the  blind  soldiers 
of  the  agricultural  class  consider  any  special  training  as 
superfluous  and  are  anxious  to  return  to  work  on  their 
own  farms  as  soon  as  possible. 

The  greatest  difficulty  arises  with  regard  to  men  be- 
longing to  the  intellectual  classes.  Most  of  them,  how- 
ever, are  officers,  and  the  relatively  larger  amount  of 
their  pension  permits  them  to  supplement  the  instruction 
given  at  the  institution  with  private  lessons.  Many 
have  been  able  to  return  to  their  former  professions,  as 
lawyers,  teachers,  and  the  like,  or  to  resume  their  aca- 
demic studies  interrupted  when  they  went  forth  to  give 
battle  to  the  civilized  world. 


134  THE      DISABLED      SOLDIER 

■  K   ■       Y 
CHAPTER  X 

IN  WAKE  OF  BATTLE'S  DIN 

For  a  number  of  men  who  return  from  the  battlefield 
the  world  of  sound  will  be  forever  closed.  From  de- 
tonation of  shells,  ear  wounds,  internal  hemorrhages,  and 
many  other  causes  men  are  deafened  at  the  front.  They 
must  face  life  again  on  a  different  basis.  f    i 

Deafness  is  really  more  an  embarrassment  than  a 
physical  handicap.  Many  occupations  are  open  to  the 
deaf,  so  that  their  earning  power  need  not  be  materially 
affected,  but  in  their  social  and  business  relationships 
they  are  apt  to  suffer  material  inconvenience  unless  the 
proper  steps  are  taken  to  help  them  surmount  their 
handicap. 

The  chief  aim  in  treating  the  returned  soldier  who  has 
been  deafened  in  battle  is  to  restore  his  capacity  for 
mingling  and  communicating  with  his  friends  and  busi- 
ness associates  with  the  least  possible  embarrassment  to 
himself  or  to  them.  It  has  been  the  experience  of  all 
who  have  studied  the  problem  that  the  best  way  to  help 
the  deafened  soldier  is  by  teaching  him  lip-reading.  Once 
he  acquires  skill  in  reading  the  lips,  he  becomes  again  a 
social  being,  cheerful  and  confident,  and  is  qualified  for 
a  great  number  of  occupations. 

Another  urgent  necessity  is  to  prevent  sensitiveness 
regarding  the  handicap.  Otherwise  a  painful  situation — 
both  for  the  deafened  soldier  and  his  associates — is  sure 
to  ensue.  When  a  nuan  overcomes  this  difficulty,  he  has 
taken  a  distinct  Step  forward  towards  success. 


WAKE      OF      battle's      DIN  135 

It  has  been  estimated  that  of  all  returned  wounded 
soldiers  one  in  fifty  suffers  from  deafness  in  a  more  or 
less  severe  form.  Returns  from  twelve  military  hospitals 
in  England  with  a  total  of  67,799  patients  in  all  show 
that  919  suffered  from  some  form  of  deafness.  Despite 
the  fact  that  the  number  of  soldiers  who  return  with 
hearing  impaired  is  comparatively  small,  the  belligerent 
countries  have  made  thoughtful  provision  for  their  suc- 
cessful reinstatement  in  civilian  life. 

First  steps  to  care  for  the  British  "Tommy"  whose 
hearing  was  impaired  were  taken  in  Edinburgh,  under 
private  auspices,  May,  1917.  Later  the  state  took  a 
hand  when  the  Ministry  of  Pensions  appointed  a  special 
Aural  Board  consisting  of  four  aural  surgeons  and  a 
lip-reading  specialist.  The  work  was  then  extended 
throughout  the  United  Kingdom. 

When  the  secretary  of  this  board  is  notified  of  the 
return  of  a  deafened  soldier,  he  communicates  with  the 
local  pensions  representative  in  the  area  in  which  the 
man  lives.  The  man  is  then  called  before  the  official 
aurists  and  lip-reading  specialists  for  examination  as  to 
his  eligibility  for  training  in  lip-reading,  for  treatment, 
or  both. 

At  the  headquarters  of  the  board  in  London  is  one  of 
the  centers  of  instruction  for  the  deaf.  Classes  are  held 
morning  and  afternoon  for  regular  pupils  and  in  the 
evening  for  those  who  are  employed  during  the  day. 

Since  the  learning  of  lip-reading  is  quite  fatiguing,  it 
is  necessary  to  provide  some  form  of  diversion  for  the 
pupils.  In  the  club  at  headquarters  the  men  are  enter- 
tained with  motion  pictures,  in  which  they  seem  to  take 
great  interest,  deriving  considerable  pleasure  from  the  fact 
that  they  can  read  the  lips  of  the  actors  on  the  screen. 


136  THE      DISABLED      SOLDIER 

One  of  the  oldest  institutions  for  the  deaf  in  France 
is  the  Institution  Nationale  des  Sourds-Muets  in  the 
rue  Saint-Jacques,  Paris.  Here  the  teaching  of  the  deaf 
has  been  going  on  for  over  a  century,  so  that  the  insti- 
tution was  ready  to  handle  the  returned  poilu  when  the 
call  came.  In  some  of  the  classes  as  many  as  eighteen 
soldier  pupils  have  been  instructed  at  the  same  time. 
Men  are  not  yet  discharged  from  the  army,  and  reside 
in  a  neighboring  military  hospital.  Printing,  tailoring, 
and  agriculture  are  the  most  successful  subjects  of  in- 
struction at  this  school. 

At  Bordeaux  the  teaching  of  the  deaf  takes  place  at  a 
convalescent  hospital  on  the  outskirts  of  the  town.  In 
some  classes  there  were  six  to  eight  deafened  pupils,  in 
others  about  double  that  number.  The  former  sized 
class  has  seemed  best  for  beginners,  but  with  more  ad- 
vanced pupils,  it  was  desirable  to  have  a  larger  number 
so  that  those  sitting  on  the  sides  could  read  lips  viewed 
more  or  less  in  profile.  Classes  could,  however,  be  held 
simultaneously  in  the  same  room,  as  the  deaf  pupils 
were  not  disturbed  by  each  other's  noises. 

It  appears  that  the  German  War  Office  established 
first  a  center  of  instruction  to  which  were  sent  for 
training  all  deafened  soldiers,  but  this  system  was  criti- 
cized on  the  ground  that  it  is  not  advisable  for  all  the 
deaf  to  be  collected  at  one  place.  By  reason  of  the 
differences  in  dialect,  it  has  been  found  better  to  send  the 
deaf  to  a  near-by  university  town,  where  there  are  ex- 
perienced teachers  of  the  deaf.  The  Germans  believe 
that  instruction  should  begin  as  soon  as  the  patient  is 
out  of  the  doctor's  care,  and  that  only  six  or  at  the  most 
eight  pupils  should  be  instructed  at  the  same  time. 


WAKE      OF      battle's      DIN  137 

The  English  regard  three  months  as  sufficient  time 
in  which  to  teach  lip-reading.  The  French  do  not 
require  that  much  time  under  their  system,  while  the 
Germans  ask  for  at  least  five  or  six  months  for  a  full 
course  of  instruction. 

With  lip-reading  thoroughly  mastered,  and  the 
deafened  soldier  being  reaccustomed  to  social  and 
business  relations  under  his  new  handicap,  almost  all 
vocations  are  open.  Men  with  a  skilled  occupation  can 
almost  universally  return  to  their  former  job.  A  few 
employments  noted  as  unfavorable  for  the  deafened  are 
those  of  chauffeur,  motorman,  conductor,  salesman, 
telephone  operator,  work  where  overhead  cranes  and 
other  shifting  machinery  is  used,  or  about  railroad 
tracks  where  hearing  is  essential  to  safety.  Regarded 
as  good  trades  are  motion  picture  operating,  photography, 
typewriting,  filing,  clerical  work  without  dictation,  farm 
work,  stock  room  or  shipping  clerk,  plumbing,  tailoring, 
bookkeeping,  printing,  baking,  and  civil  service  positions. 

Among  sixty-nine  deafened  soldiers  trained  at  Lyons, 
France,  thirty-nine  were  prepared  for  agriculture,  eleven 
for  manufacturing,  nine  for  commerce,  and  ten  for  mis- 
cellaneous jobs. 

The  Division  of  Physical  Reconstruction  of  the  United 
States  Army,  under  the  Surgeon  General,  has  established 
through  its  Section  of  Defects  of  Hearing  and  Speech 
a  center  for  treatment  in  connection  with  United  States 
Army  General  Hospital  No.  11,  at  Cape  May,  N,  J. 

After  a  thorough  consideration  of  all  the  methods 
employed  by  the  other  countries,  both  allied  and  enemy, 
it  was  considered  that  the  best  manner  in  which  to 
handle  reconstruction  patients  along  this  line,  was  to 
establish  a  central  point  at  which  they  could  be  treated 


138  THE      DISABLED      SOLDIER 

under  full  military  discipline.  It  was  decided  that  it 
was  impossible  to  define,  when  a  patient  was  first  ad- 
mitted into  the  hospital,  whether  he  was  a  patient 
appropriate  for  discharge  along  one  of  the  three  lines  into 
which  reconstruction  patients  are  to  be  classified,  until 
he  was  thoroughly  subjected  to  the  line  of  treatment 
that  was  thought  adequate  for  his  condition.  Not  only 
this,  but  it  would  seem  from  the  work  in  connection  with 
the  British  and  other  allied  nations*  reconstruction  en- 
deavors, that  the  most  advantageous  course  to  be  pur- 
sued in  connection  with  these  men  was  to  hold  them  in 
the  army  until  physically  qualified  thoroughly  to  take 
care  of  themselves  in  their  contact  with  the  outside 
world. 

Actuated  by  these  two  motives,  the  chief  of  the  section 
decided  to  concentrate  all  ambulatory  cases  at  United 
States  Army  General  Hospital  No.  11.  Cases  with 
multiple  injuries  and  other  diseases  which  necessitate 
their  being  retained  in  other  United  States  Army  general 
hospitals  will  receive  their  treatment  in  these  hospitals, 
from  reconstruction  aides  who  will  be  transferred,  dur- 
ing such  course  of  treatment  to  the  hospital  at  which 
the  patient  is  confined.  By  this  means  the  patients 
receive  both  their  general  medical  and  surgical  treatment 
as  well  as  their  aural  treatment.  This  at  the  same  time 
minimizes  the  period  of  time  which  the  patients  will 
have  to  spend  in  the  hospital. 

The  wisdom  of  this  procedure  has  already  been  demon- 
strated during  the  three  months  in  which  the  activities 
of  the  section  have  been  progressing  in  connection  with 
this  work. 

It  must  be  understood  that  patients  are  receiving 
treatment  along  all  lines  which  aid  in  their  restoration. 


WAKE      OF      battle's      DIN  139 

These  men  are  thoroughly  and  carefully  classified.  Many 
of  them  require  thorough  surgical  and  medical  treatment 
besides  those  measures  which  are  essential  to  their  audi- 
tory re-education.  The  auditory  re-education  is  not 
entirely  along  one  line  of  treatment.  Besides  the  various 
types  of  medical  attention  given  these  individuals,  aur- 
icular and  speech  reading  methods  are  also  employed. 

One  of  the  first  men  to  be  deafened  in  France  was 
illiterate  and  so  must  needs  be  trained  to  read  and  write 
as  well  as  to  interpret  the  movement  of  the  lips  in  terms 
of  sound.  The  patients  at  United  States  Army  General 
Hospital  No.  11  have  shown  that  true  American  spirit 
of  enthusiasm  and  effort.  Results  indicate  that  the 
average  period  of  treatment  and  training  equals  the 
French,  and  probably  exceeds  it. 

An  unofificial  service  to  cooperate  with  the  government 
authorities  has  been  organized  by  the  Industrial  Union 
for  the  Deaf  and  the  Volta  Bureau.  The  objects  of  this 
service  are  to  aid  men  to  retain  their  former  powers  of 
speech  which  are  likely  to  suffer  from  disuse,  to  teach 
them  to  read  the  lips  as  rapidly  as  possible,  to  educate 
employers  to  a  realization  of  the  value  of  lip-reading  and 
thus  pave  the  way  for  the  employment  of  the  deaf, 
where  some  hearing  is  left  to  develop  and  re-educate 
that  hearing  in  the  hopes  of  possible  recovery,  and  to 
offer  vocational  advice  to  those  who  must  enter  new 
and  unaccustomed  fields  of  labor.  Facilities  for  the  edu- 
cation of  the  deaf  are  excellent  in  the  United  States,  and 
all  will  be  at  the  service  of  the  deafened  soldier,  should 
their  utilization  seem  wise. 

A  rather  exceptional  opening  for  the  deaf  is  in  plants 
where  the  noise  is  such  as  to  impair  the  hearing  of  normal 
workers.    One  concern  which  used  to  deafen  totally  or 


140  THE      DISABLED      SOLDIER 

partially  each  year  scores  of  employees  has  now  stopped 
the  damage  by  seeking  out  for  the  jobs  men  already  deaf, 
who  will  suffer,  therefore,  no  further  injury.  Compensa- 
tion expense  has  been  cut  to  a  minimum,  and  deaf  can- 
didates for  employment  are  at  a  premium. 

An  encouraging  augury  of  the  attitude  of  American 
employers  toward  the  discharged  deafened  soldier  is  the 
present  intelligent  utilization  of  deaf  workmen  in  some 
of  the  largest  plants.  One  tire  concern,  for  example, 
has  four  hundred  employees  who  cannot  hear,  and  an 
automobile  concern  lists  three  hundred  more  on  its 
payroll. 

With  modern  provision  the  transition  of  the  deafened 
man  from  the  din  of  the  battlefield  to  profitable  employ- 
ment in  industry  can  be  accomplished  with  difficulty 
slight  indeed. 


THE      STEP      IN      TikE  141 


CHAPTER  XI 

THE  STEP  IN  TIME 

The  greatest  number  of  discharges  from  the  army  for 
physical  disabiUty  for  any  specific  cause  is  chargeable  to 
pulmonary  tuberculosis.  The  largest  number  of  pensions 
awarded  in  Great  Britain  up  to  January,  1918,  went  to 
men  with  lung  diseases,  which  accounted  for  twelve 
per  cent,  of  the  total  disability  grants  made,  and  by  the 
end  of  1917,  a  total  of  20,000  British  soldiers  had  been 
invalided  home  for  pthisis.  The  early  discharges  from 
our  own  army  in  camp  and  field  were  of  men  who  had 
developed  a  tuberculous  condition. 

Many  of  the  cases  were  due  to  imperfect  medical 
examination  at  the  time  of  admission  to  the  army,  a 
considerable  number  of  active  cases  of  tuberculosis  being 
passed  in  the  first  rush  of  recruiting  and  conscription. 
Some  oversights  were  due  to  carelessness  of  medical 
examiners,  others  to  the  fact  that  it  is  difficult  for  a 
physician  without  special  experience  in  dealing  with  the 
tuberculous  to  detect  cases  in  the  incipient  stages. 

There  was  ample  warning  in  the  experience  of  other 
countries  as  to  the  importance  of  the  examination  for 
tuberculosis.  Canadian  representatives  warned  that  it 
should  have  special  attention,  adding  the  caution  that 
every  case  missed  would  cost  the  government  over  five 
thousand  dollars.  And  care  was  taken,  but  in  spite  of 
it,  a  certain  number  of  men  slipped  through. 

The  interesting  thing  about  discharges  for  tuberculosis 
is  that  the  disease  is  almost  never  contracted  in  the 


142 THE      DISABLED      SOLDIER 

army  but  is  brought  in  during  its  active  condition  or, 
more  frequently,  while  latent  or  quiescent.  In  the  latter 
instance  the  rigors  and  exertion  of  camp  life  have  lighted 
the  sleeping  fires  and  made  the  case  active.  While  the 
original  infection,  therefore,  accurately  speaking,  was 
not  incurred  in  military  service,  the  state  of  active 
tuberculosis  was  due  to  army  work  and  would  probably 
not  otherwise  have  existed. 

The  tuberculous  soldier  almost  universally  desires  im- 
mediate discharge  from  the  army,  award  of  his  compen- 
sation for  disability,  and  permission  to  return  to  his 
home.  This  would  mean,  in  almost  every  instance, 
that  his  condition  would  grow  progressively  worse  rather 
than  better.  The  ideal  arrangement  would  be  for  him 
to  remain  in  the  army  for  treatment  until  he  is  cured,  or 
at  least  until  his  case  is  substantially  arrested.  During 
the  period  of  care  his  family  will  be  provided  for  by  the 
allotment  of  military  pay,  and  the  additional  allowances 
made  by  the  government.  The  opportunity  of  free 
treatment  and  support  of  himself  and  his  family  until 
he  is  cured  is  one  that  will  never  come  to  him  again. 
Propaganda  to  educate  the  public  to  wisdom  regarding 
the  disabled  can  greatly  further  the  probability  of  the 
tuberculous  consenting  to  treatment. 

Even  though  the  man  knows  that  it  is  the  best  thing 
for  his  health,  it  is  hard  for  him  to  make  up  his  mind  to 
leave  his  family  for  a  year  or  possibly  for  longer,  to  go 
alone  to  a  sanatorium.  He  may  conceivably  prefer  to 
take  his  chances  on  the  question  of  health  and  life.  The 
matter  is  made  much  the  more  difficult  by  the  location 
of  some  of  the  military  hospitals  at,  seemingly,  the  ends 
of  the  earth,  where  it  is  out  of  the  question  that  he 
could  ever  be  visited  by  his  family.    Were  units  for  the 


THE      STEP      IN      TIME  143 

tuberculous  made  more  accessible,  it  is  likely  that  the 
plans  for  treatment  would  be  more  readily  acceded  to, 
and  the  families  of  the  men,  seeing  with  their  own  eyes 
from  time  to  time  the  progress  made,  would  more  easily 
be  reconciled  to  continuance  of  the  treatment. 

Even  if  a  man  is  reluctant  to  enter  upon  a  long  term 
of  treatment,  a  short  period  under  regular  medical  super- 
vision will  do  him  a  great  deal  of  good,  in  that  he  will 
learn  how  to  protect  others  from  infection  at  his  hands, 
and  will  become  acquainted  with  the  principles  of  fresh 
air,  food,  sleep,  and  the  like  which  he  can  follow  out 
after  his  return  home  in  the  form  of  self-treatment.  In 
other  words,  he  will  learn  the  factors  upon  which  re- 
covery from  tuberculosis  depends,  and  will  have  become 
accustomed  in  some  degree  to  the  daily  regime.  It  is 
largely  for  this  reason  that  the  Surgeon  General  of  the 
Army  has  ruled  that  all  tuberculous  soldiers  must  be 
retained  under  treatment  for  at  least  three  months. 

Ever  since  it  has  been  demonstrated  that  occupational 
therapy  is  of  great  value  in  the  treatment  of  the  most 
varied  disabilities,  the  question  of  its  possible  value  in 
the  treatment  of  tuberculosis  has  been  the  subject  of  no 
little  debate.  Many  American  and  German  specialists 
have  maintained  that  if  a  permanent  arrest  of  lung- 
disease  is  to  be  secured,  a  prolonged  period  of  rest  must 
be  taken  by  the  patient  and  that  this  rest  must  be 
"surgical  rest"  as  long  as  active  symptoms  continue 
or  so  long  as  fever  persists.  English  specialists,  however, 
appear  generally  to  believe  in  prescribing  a  considerable 
amount  of  vocational  work  in  all  except  the  hopeless 
cases,  and  as  soon  as  the  patient  who  has  a  "chance" 
loses  the  most  distressing  symptoms.  The  exercise  pre- 
scribed is  at  first  walking  only,  but  "such  monotonous 


144  THE      DISABLED      SOLDIER 

occupation  is  gradually  replaced  by  light  and  useful 
work,  increased  little  by  little  until  at  last,  before  their 
discharge,  the  most  favorable  cases  do  six  hours'  hard 
navvy  work  a  day." 

There  can  be  no  doubt  that  some  forms  of  occupational 
activity  are  of  great  advantage  in  the  treatment  of  the 
tuberculous  soldier,  if  only  for  psychological  reasons. 
For  there  is  a  difference  between  the  frame  of  mind  in 
which  a  civilian  afflicted  with  the  disease  enters  upon 
the  treatment,  and  the  attitude  of  the  soldier  who  is 
sent  to  a  sanatorium.  It  has  been  reported,  for  instance, 
that  in  the  Canadian  military  hospital  at  Ste.  Agathe 
des  Monts,  Quebec,  "on  account  of  the  excitement, 
danger,  and  adventure  of  their  life  at  the  front"  the 
invalided  soldiers  "were  not  only  indifferent  to  the  ordi- 
nary methods  of  treatment" — prolonged  rest,  followed, 
after  many  months,  it  may  be,  by  gradually  increased 
"doses"  of  mild  exercise — "but  openly  rebellious  against 
such  methods."  Within  six  months  of  the  opening  of 
this  sanatorium,  one-third  of  the  soldiers  had  refused  to 
continue  the  treatment,  and  fifteen  per  cent,  had  to  be 
dismissed  for  "open  insubordination  usually  terminating 
in  drunkenness."  After  this  experience,  treatment  along 
vocational  lines,  less  strenuous  than  that  advocated  by 
the  English  experts,  was  resorted  to,  and  with  very 
satisfactory  results.  Enthusiasm  for  the  treatment  has 
replaced  the  former  indifference,  insubordination  has 
been  reduced  to  less  than  two  per  cent.,  and  instead  of 
refusal  of  treatment,  there  have  been  applications  for 
extension  of  time  to  permit  vocational  courses  to  be 
completed. 

This  experience  makes  it  clear  that  the  tuberculous 
soldier  presents  a  special  problem,  in  that  methods  to 


THE      STEP      IN      TIME  145 

which  a  civilian  submits  voluntarily  and  without  a 
murmur  become  dangerous  because  of  their  psychological 
effect  on  the  average  soldier,  the  prolonged  rest  seeming 
nothing  more  than  enforced  idleness,  leading  therefore 
to  irritation,  depression,  discontent,  boredom,  and  fre- 
quently to  sudden  rash  acts.  Obviously,  all  these  unde- 
sirable results  can  do  more  to  delay  improvement  than 
a  system  of  well-regulated  occupational  therapy  pos- 
sibly can. 

The  soldiers'  sanatorium  at  Ste.  Agathe,  Canada,  is 
typical  of  many  establishments  that  have  been  founded 
the  world  over  to  care  for  the  unprecedented  numbers  of 
disabled  soldiers.  Ste.  Agathe  is  a  sleepy,  picturesque 
French- Canadian  hamlet  four  hours'  train  journey  into 
the  hills  and  forests  northwest  of  Montreal;  before  the 
war  it  had  its  summer  colony,  its  winter  sports,  its  inn, 
and  a  sanatorium  for  tuberculous  civilians.  In  the 
winter  of  1916,  the  inn  was  taken  over  for  the  treatment 
of  tuberculous  soldiers  by  the  Canadian  government,  and 
converted  into  a  sanatorium  with  a  capacity  of  seventy- 
six  beds.  Since  that  time,  the  other  sanatorium,  which 
still  has  its  quota  of  civilian  patients  to  care  for,  has 
placed  fifty  beds  at  the  disposal  of  the  military.  After 
the  exf)erience  to  which  reference  has  been  made,  the 
military  hospital  was  provided  with  specially  designed 
workshop  and  school  buildings. 

In  accordance  with  common  sanatorium  practice,  the 
soldier-patients  at  Ste.  Agathe  are  divided  into  three 
classes.  The  first  class  consists  of  infirmary  cases,  in 
whom  the  disease  is  in  its  acute  stage;  they  are  confined 
to  bed  until  the  distressing  symptoms  disappear.  Under 
careful  supervision,  these  patients  are  permitted  to 
beguile  the  tedium  of  the  sick  room  with  knitting,  draw- 


146  THE      DISABLED      SOLDIER 

ing,  crocheting,  cardboard  work,  raffia  weaving,  and 
study. 

The  second  class  consists  of  porch  cases — those  which 
have  progressed  so  far  as  to  go  to  the  dining  room  for 
meals  and  look  after  themselves,  spending  the  day  on 
reclining  chairs  in  the  open  air.  In  addition  to  the  occu- 
pations permitted  the  infirmary  cases,  porch  patients 
may  take  up  reed  basketry,  stenography,  and  penman- 
ship as  their  strength  increases — but  always  under  careful 
surveillance.  On  the  first  indication  of  trouble,  they  are 
immediately  returned  to  the  former  classification  until 
all  danger  is  passed. 

Class  three  is  subdivided  into  six  groups,  according  as 
the  time  prescribed  for  exercise  and  vocational  therapy 
varies  from  fifteen  minutes  to  two  hours  daily.  As  soon 
as  a  patient  has  progressed  to  the  point  where  he  can  be 
permitted  half  an  hour's  exercise  a  day,  he  is  given  the 
opportunity  of  spending  half  this  time  in  the  workshop. 
Class  three  patients  are  offered  the  choice  of  instruction 
in  basketry,  carving,  clay  modelling,  metal  work,  picture 
framing,  illuminating,  engraving,  or,  in  the  school  build- 
ing, of  instruction  in  French,  English,  and  in  subjects 
preparatory  for  civil  service  positions.  In  the  summer, 
the  more  favorable  cases  take  up  a  little  gardening.  As 
in  the  second  class,  these  patients  are  constantly  watched 
for  dangerous  symptoms;  as  soon  as  any  appear,  the 
patient  is  returned  to  a  less  advanced  category. 

The  workshop  and  the  school  are  very  simple  structures 
designed  to  afford  the  maximum  of  fresh  air  and  comfort. 
The  classes  are  well-attended,  and  relapses  are  rare. 
Twenty-nine  out  of  thirty-two  patients  who  prepared  for 
civil  service  positions  have  since  passed  their  examina- 
tions with  good  averages. 


THE      STEP      IN      TIME  147 

The  great  defect  of  sanatorium  treatment  has  hitherto 
been  the  fact  that  a  large  number  of  cases  discharged 
with  the  disease  apparently  arrested  sooner  or  later 
suffer  a  relapse.  This  has  been  true  particularly  of  those 
patients  who  must  support  themselves,  usually  at  some 
manual  trade.  The  chief  reason  for  this  condition  is 
doubtless  the  fact  that  the  sudden  change  from  perfectly 
hygienic  surroundings  with  plenty  of  good  food  and  fresh 
air  and  medical  attention  to  the  conditions  under  which 
the  less  well-off  must  so  frequently  live  and  work  is  a 
strain  which  many  patients  cannot  withstand.  It  is 
therefore  important  that  the  period  after  discharge  be 
wisely  considered  and  planned  for. 

With  this  fact  in  mind,  the  army  medical  authorities 
in  the  various  belligerent  countries  both  at  home  and 
abroad  have  taken  a  number  of  preventive  and  precau- 
tionary measures  with  regard  to  this  critical  period.  One 
of  the  obvious  steps  was  the  consideration  of  vocational 
possibilities.  All  occupations  involving  severe  physical 
exertion  or  prolonged  stay  in  a  dust-laden  atmosphere 
are  impossible.  The  best  seem  to  be  outdoor  and  semi- 
outdoor  occupations  ranging  from  farmer  to  chauffeur, 
from  policeman  to  ticket-collector  and  traveling  sales- 
man, and  the  like.  Most  patients  seem  to  prefer,  how- 
ever, to  return  to  their  original  vocations;  and  whenever 
the  working  conditions  permit  it  the  authorities  make 
no  objection.  Even  the  best  occupations  have  features 
that  are  not  ideal  for  the  worker  with  a  tubercular  his- 
tory. Indeed,  the  factors  that  enter  into  the  problem 
are  so  many  and  varied  that  almost  every  case  must  be 
judged  on  its  own  merits.  Nevertheless,  it  is  most  im- 
portant that  it  be  so  judged,  and  that  steps  be  taken  in 
each  case  to  eliminate  as  many  objectionable  features 


148  THE      DISABLED      SOLDIER 

obtaining  under  the  former  working  and  living  conditions 
as  possible.  In  Germany  the  organized  cooperation  of 
the  employer  in  this  direction  is  asked  for. 

Recognizing  the  vital  importance  of  the  post-sana- 
torium period,  the  Surgeon  General  of  the  United  States 
Army  has  approved  a  plan  for  "after-care"  which  involves 
the  cooperation  of  various  civilian  agencies.  Cooperation 
is  secured  through  the  National  Tuberculosis  Associa- 
tion. This  body  forwards  the  names  of  all  soldiers  in- 
valided because  of  lung-disease,  and  of  all  civilians 
rejected  for  army  service  for  the  same  reason,  to  such 
local  organizations  as  public  health  boards,  state  anti- 
tuberculosis societies,  and  the  local  agencies  of  civilian 
relief  of  the  Red  Cross.  These  agencies  share  the  work 
of  supplying  the  War  Risk  Insurance  Bureau  with  the 
required  data  concerning  the  economic  and  social  cir- 
cumstances of  the  disabled  soldier  and  his  family,  of 
providing  such  medical  examination,  attendance,  and 
other  care  as  may  be  needed,  the  Red  Cross  assuming 
the  burden  of  supplying  the  family  with  any  necessary 
financial  relief  during  the  period  before  this  duty  is  taken 
over  by  the  proper  community  relief  organization. 

Another  step  in  the  direction  of  "after-care"  that  seems 
to  have  been  taken  simultaneously  in  the  United  States, 
in  England,  in  Germany,  and  perhaps  elsewhere,  is  the 
development  of  an  institution  that  is  to  serve  as  an  inter- 
mediate step  between  release  from  the  sanatorium  and 
return  to  complete  economic  usefulness.  In  England 
these  institutions  are  called  "farm  colonies,"  in  Germany, 
"convalescent  work-homes";  in  the  United  States  they 
have  as  yet  received  no  generic  designation.  But  the 
purpose  of  them  all  is  very  much  the  same — to  take  up 
the  treatment  where  the  sanatorium  must  properly  drop  it. 


THE      STEP      IN      TIME  149 

The  sanatorium  strives  to  retain  its  patients  until  the 
disease  is  diagnosed  .as  "quiescent"  or  "arrested."  The 
patient  so  released  is  rarely  in  possession  of  his  full 
strength.  He  has  been  living  an  artificially  sheltered  life, 
even  though  he  may  have  been  engaged  in  vocational 
work  for  a  number  of  hours  daily  prior  to  his  discharge. 
Psychologically  and  physiologically  he  is  not  always  fit 
to  resume  forthwith  the  struggle  for  existence  among  his 
fellows.  It  is  at  this  point  that  these  new  institutions 
fit  in,  their  primary  purpose  being  to  bridge  the  gap,  to 
provide  a  "hardening"  period.  A  secondary  but  very 
important  purpose  is  to  continue  the  vocational  training 
already  begun  in  the  sanatorium. 

These  institutions  take  various  forms.  In  New  York 
City,  after  an  investigation  had  revealed  the  fact  that 
forty-five  per  cent,  of  the  patients  of  a  certain  sanatorium 
had  relapsed  or  died  within  six  monhs  to  two  years  after 
their  discharge,  the  Committee  for  the  Care  of  the  Jewish 
Tuberculous  decided  on  a  system  of  after-care,  one  of 
the  features  of  which  was  the  establishment  of  a  factory 
for  employment  of  some  of  the  cases.  Since  over  sixty 
per  cent,  of  their  charges  were  needle-workers,  the  factory 
was  fitted  up  to  enter  this  field  of  work.  An  ordinary 
well-lighted  loft  was  rented,  additional  windows  sup- 
plied, machinery  installed.  The  windows  are  always 
kept  open,  a  comfortable  temperature  is  maintained,  the 
strictest  hygienic  conditions  prevail.  Only  "negative 
sputum"  cases  are  accepted.  For  a  number  of  months 
after  admittance,  the  workers  are  examined  every  week 
or  two,  later  on  every  three  or  four  weeks,  and,  after  six 
months,  every  four  or  five  weeks.  Work  is  paid  for  on  a 
piece  work  basis  at  rates  at  least  as  good  as  those  ob- 
tained by  normal  workers  elsewhere.     The  employees 


150  THE      DISABLED      SOLDIER 

work  from  two  to  eight  hours  daily,  according  to  the 
doctor's  ruling. 

As  a  result  of  this  intermediate  institution  and  other 
after-care — such  as  visiting,  home-instruction  in  hygiene 
and  treatment,  the  provision  of  financial  aid  when  neces- 
sary, and  the  like — relapses  have  been  kept  down  to 
fifteen  per  cent.  In  a  recent  report  by  the  director  of 
this  institution  it  was  emphasized  that  for  the  past 
seventeen  months  the  factory  has  been  entirely  self- 
supporting.  It  is  probable  that  similar  institutions  will 
play  a  part  in  the  after-care  of  the  military  tuberculous. 

It  will  not  be  long,  doubtless,  before  large  industrial 
establishments  will  find  their  way  toward  cooperating  in 
this  work  by  assigning  certain  positions — whole  depart- 
ments, perhaps — especially  suited  to  the  tuberculous  as 
opportunity  for  either  the  permanent  employment  of 
such  workers  or  for  employment  during  the  hardening  or 
post-sanatorium  period.  One  of  our  largest  automobile 
factories  has  already  undertaken  cooperation  of  this  sort. 

Great  benefit  to  the  community  will  ensue  from  suc- 
cessful provision  of  after-care  for  tuberculous  soldiers, 
and  conversely  great  injury  will  result  from  half-hearted 
attention  to  the  problem. 


BRINK      OF      THE      CHASM  151 

CHAPTER  XII 

BRINK  OF  THE  CHASM 

The  force  of  modern  high  explosives  and  the  strain  of 
trench  warfare  have  added  to  the  old  sad  list  of  soldiers' 
disabilities  a  new  one,  known  as  shell  shock.  The  term  is 
familiar  to  everybody,  but  probably  many  people  have 
no  very  definite  idea  of  the  condition  it  describes. 

You  may  have  seen  a  Canadian  officer  home  on  a  fur- 
lough, suffering,  you  are  told,  from  shell  shock,  and  have 
remarked  his  haggard  eyes,  his  nervous  starts,  the  reso- 
lute grip  on  his  cane  by  which  he  tried  to  conceal  the 
trembling  of  his  hand.  Or  you  may  have  read  of  shell 
shock  victims  in  the  hospitals,  men  who  jerk  and  shake 
in  every  limb,  whose  minds  have  become  a  blank,  or  who 
are  blind  and  deaf  from  shock.  You  have  perhaps  not 
realized,  however,  that  shell  shock  is  only  a  new  expres- 
sion for  an  old  class  of  diseases,  diseases  of  the  nervous 
system  which  attack  men  in  peace  or  in  war  when  they 
undergo  great  strain  or  shock.  Shell  shock  is  simply  a 
collective  term  for  the  well  known  psychoneuroses, 
hysteria,  neurasthenia,  and  the  like,  brought  on  by  the 
events  of  the  war.  A  more  accurate  term  would  be  "war 
psychoneuroses"  or  merely  "war-neuroses."  The  war- 
neuroses,  just  as  the  neuroses  of  ordinary  life,  are  purely 
functional  nervous  affections  and  are  not  caused  by  a 
physical  injury  to  a  nerve  or  to  the  brain.  A  victim 
of  shell  shock  may  be  unable  to  raise  his  arm  or  to  speak, 
but  his  condition  is  utterly  different  from  that  of  the 
man  whose  arm  is  paralyzed  because  the  ulnar  nerve 


152      THE   DISABLED   SOLDIER 

has  been  severed  by  a  bullet  or  who  has  lost  his  speech 
from  a  shell  splinter  in  his  brain.  In  the  shell  shock 
patient  the  psychic  impulse  to  move  the  arm  or  to  speak 
cannot  be  translated  into  action ;  apparently  the  patient 
has  forgotten  completely  how  to  move  the  arm  or  how 
to  speak  although  the  physical  mechanism  for  the  move- 
ment or  speech  remains  intact. 

The  number  of  men  disabled  in  the  present  war  by 
nervous  and  mental  diseases — shell  shock,  hysteria,  neu- 
rasthenia, and  insanity — is  large,  but  perhaps  not  sur- 
prisingly so  when  one  considers  the  almost  superhuman 
endurance  and  fortitude  demanded  of  the  modern  soldier. 
In  British  pension  statistics  dealing  with  men  discharged 
from  the  army  up  to  May,  1918,  shell  shock  ranks  with 
the  major  disabilities,  accounting  (with  insanity  and 
epilepsy)  for  seven  per  cent,  of  the  discharges.  During 
the  same  period  rheumatism  disabled  only  six  per  cent, 
and  tuberculosis  eleven.  These  figures  do  not,  however, 
represent  the  full  total  of  the  nervously  disabled,  for 
many  men  discharged  for  other  disabilities  also  suffer 
from  nervous  disorders.  The  number  of  British  pen- 
sioners afflicted  with  nervous  diseases  is  stated  by  one 
authority  to  be  nearly  twenty  per  cent,  of  the  total. 

Cases  of  insanity  among  soldiers  differ  from  those 
occurring  among  civilians  only  in  the  war  coloring  of  the 
sufferers'  delusions.  In  the  allied  countries  they  are 
treated  by  the  army  medical  service  until  they  recover 
or  until  they  are  recognized  as  incurable,  when  they  are 
sent  to  regular  hospitals  for  the  insane. 

Classed  together  under  the  term  shell  shock  are  many 
different  kinds  and  degrees  of  nervous  disorder.  These 
range  from  a  temporary  loss  of  self-control  to  such  a 
severe  shattering  of  the  nerves  that  the  patient  is  a 


BRINK      OF      THE      CHASM  153 

mental  and  physical  wreck.  Symptoms  vary  greatly  in 
different  individuals  and  are  both  mental  and  physical 
in  character.  Some  men  appear  tired  and  depressed; 
others  are  irritable,  worried,  or  terrified.  They  are  usu- 
ally afflicted  by  severe  headaches,  and  at  night  they  are 
troubled  by  violent  nightmares.  A  common  type  of 
war-neurosis  is  the  hypochondriac  with  his  thoughts 
constantly  centered  upon  his  real  and  imaginary  pains. 
Inability  to  concentrate  the  attention  on  anything  marks 
another  type,  and  still  different  is  the  man  who  sinks  into 
complete  mental  torpor,  sitting  for  days  indifferent  to 
all  around  him,  too  apathetic  to  wipe  away  a  tear  that 
may  roll  out  of  his  eye.  Other  mental  symptoms  are 
tangled  thoughts  and  partial  or  total  loss  of  memory. 
On  the  physical  side,  the  victim  of  shell  shock  frequently 
has  a  disordered  heart  action  and  strange  tremors  in  his 
limbs.  His  head  may  waggle  uncontrollably  and  piti- 
fully, or  his  feet  drag  helplessly  along  the  floor.  Among 
the  severer  effects  are  puzzling  cases  of  muscle  contrac- 
tions and  paralyses,  authentic  signs  of  physical  injury 
without  a  scratch  on  the  body.  A  large  number  of  shell 
shock  cases  lose  temporarily  their  sight,  hearing,  or 
speech,  becoming  in  all  reality  blind,  deaf,  or  dumb 
though  there  has  been  no  injury  to  their  sensory  organs 
or  nerves. 

The  derangement  of  the  nervous  system  indicated  by 
these  symptoms  is  inadequately  described  by  the  term 
shell  shock,  for  the  condition  occurs  in  men  who  have 
never  heard  an  exploding  shell.  It  is  not  necessarily 
caused  by  the  concussion  of  high  explosives  with  the 
accompanying  noise  and  horrid  sights — the  psychic 
trauma  of  battle — but  is  as  often  brought  on  by  the 
physical  and  emotional  strains  the  soldier  has  to  bear. 


154  THE      DISABLED      SOLDIER 

Great  fatigue,  lack  of  sleep,  cold,  hunger,  mud,  and  filth 
wear  a  man  down  to  the  breaking  point.  Then  fear 
begins  to  clutch  at  him,  and  worse,  the  fear  of  being 
afraid.  He  struggles  with  his  fear  and  conquers  it,  but 
each  victory  is  at  the  cost  of  nervous  energy.  He  sup- 
presses all  expression  of  his  emotions  and  cultivates  a 
soldierly  indifference  to  the  loss  of  comrades  and  the 
ghastly  incidents  of  war,  but  the  suppressed  feelings  wait 
their  chance  to  gain  the  upper  hand.  At  any  time  now 
the  collapse  may  occur,  or  it  may  hold  off  until  it  is  pre- 
cipitated by  some  violent  shock — the  explosion  of  a  shell 
which  buries  him  beneath  corpses  and  debris,  or  bad 
news  in  a  letter  from  home. 

Even  when  the  actual  atmospheric  concussion  from  an 
exploding  shell  is  violent  enough  to  knock  a  man  uncon- 
scious, it  does  not  appear  to  be  the  prime  cause  of  the 
nervous  collapse.  Men  who  are  severely  injured  by  shell 
fragments  are  only  slightly  affected  by  shell  shock,  while 
men  who  escape  serious  bodily  injury  suffer  the  greatest 
nervous  disturbance.  As  has  been  said,  the  physical 
and  emotional  strains  of  the  soldier's  life  play  an  im- 
portant part  in  the  result,  but  in  many  cases  the  deter- 
mining cause  is  an  innate  nervous  instability,  a  predis- 
position to  hysteria  or  neurasthenia.  Many  men  are 
temperamentally  unfit  to  be  soldiers,  and  these  are  the 
likeliest  victims  of  shell  shock.  They  are  often  men  who 
have  displayed  great  bravery,  men  who  have  volunteered 
for  desperate  trench  raids  or  to  carry  despatches  through 
a  barrage,  but  they  lack  the  nervous  energy  for  keeping 
up  their  effort.  Far  from  being  a  reflection  on  a  man's 
courage,  shell  shock  shows  that  he  has  spent  himself  to 
the  utmost. 


BRINK      OF      THE      CHASM 155 

When  a  man  is  nervously  spent,  his  will  loses  the  mas- 
tery and  long  suppressed  desires  or  fears  rule.  In  the 
shell  shock  victim  the  dread  of  battle,  the  fear  of  death 
and  injury,  so  long  kept  under,  holds  sway  over  both 
mind  and  body.  The  man  is  not  a  malingerer,  but  his 
mind  exerts  a  subconscious  influence  on  his  bodily  con- 
dition. While  his  body  is  unfit,  he  cannot  go  back  to  the 
front;  under  the  influence  of  his  ruling  wish  to  escape 
further  suffering,  his  body  therefore  refuses  to  mend. 
Many  cases  of  shell  shock  are  clear  examples  of  such 
hysteria.  One  case  reported  by  an  Austrian  physician 
was  of  a  South  Slav  soldier  whose  leg  after  shell  shock 
remained  stiff  for  many  months.  In  the  course  of  the 
man's  hospital  sojourn  he  contracted  tuberculosis,  a 
ground  for  discharge  from  service,  and  the  leg  rapidly 
recovered.  In  other  recorded  instances,  where  the  eye- 
sight has  been  temporarily  lost,  the  sight  has  returned 
most  slowly  to  the  shooting  eye. 

The  treatment  prescribed  for  shell  shock  cases  in  the 
early  acute  stage  is  rest  in  bed,  good  food,  and  cheerful 
surroundings.  This  treatment  is  provided  for  the 
British  and  French  armies  in  special  shock  hospitals  just 
behind  the  lines.  Under  it  a  large  proportion  of  the  cases 
rapidly  recover  and  in  three  or  four  weeks  are  usually 
sent  back  to  the  front.  Cases  which  show  that  they  will 
not  recover  quickly  are  evacuated  to  the  base  hospitals, 
and  then,  if  they  are  British  soldiers,  are  sent  back  to 
England,  the  milder  cases  to  general  convalescent  hospi- 
tals and  the  severer  ones  to  special  neurological  institu- 
tions. Discharged  soldiers  still  suffering  from  nervous 
disccises  are  able  to  obtain  additional  treatment  in  certain 
so-called  Homes  of  Recovery  organized  for  their  benefit 
by  the  Pensions  Ministry.    These  Homes  of  Recovery 


156  THE      DISABLED      SOLDIER 

have  done  invaluable  work  in  restoring  to  nerve-shattered 
ex-soldiers  the  ability  to  live  and  work  as  normal  men. 
Their  success  seems  to  have  been  due  not  a  little  to  the 
fact  that  the  men  taking  treatment  have  no  fear  of  being 
returned  to  the  front  when  they  are  cured. 

Segregation  in  special  institutions  seems  on  the  whole 
desirable  for  nervous  patients.  Against  it  has  been 
urged  the  facts  that  a  patient's  depression  or  irritability 
may  be  increased  by  his  companions'  nerves  and  that  he 
is  apt  to  imitate  others'  symptoms,  but  these  arguments 
have  not  been  supported  by  experience.  On  the  other 
hand  it  has  been  found  that  a  nervous  case  in  the  general 
wards  of  a  hospital  attracts  painful  attention  from  the 
other  patients,  and  that  his  tremors,  stuttering,  or 
shuffling  gait  are  made  the  subject  of  their  jokes.  A  man 
whose  ills  are  what  wounded  men  call  imaginary  can 
expect  from  them  little  sympathy. 

In  any  institution  where  shell  shock  cases  are  suc- 
cessfully treated,  the  greatest  care  is  taken  to  make  the 
surroundings  cheerful  and  to  have  the  atmosphere 
charged  with  optimism.  Patients  of  this  kind  are  ex- 
tremely sensitive  to  suggestion.  If  they  are  to  recover, 
everything  around  them  must  suggest  hope  and  recovery. 
The  first  step  in  the  cure  is  to  make  them  believe  they 
are  going  to  get  well.  In  this  task  the  personality  of 
doctors  and  nurses  plays  a  big  role.  They  must  have 
common  sense,  real  sympathy,  the  strength  of  will  to 
disguise  it,  and  great  confidence,  but  above  all  the  power 
to  command  their  patients'  confidence. 

It  is  the  doctor's  first  duty  to  find  out  what  is  worry- 
ing his  patients.  He  may  use  the  simple  method  of 
sympathetic  questioning  or  the  modern  psychoanalysis, 
but    his  aim   is  always   to  bring  to  light   the  hidden 


BRINK      OF      THE      CHASM  157 

complex  which  is  at  the  root  of  their  nervous  symptoms. 
He  then  tries  to  make  the  patients  understand  their 
symptoms,  to  face  squarely  the  facts  responsible  for  their 
breakdown,  and  to  build  up  their  will  power.  Physical 
treatment,  such  as  electric  currents,  baths,  and  massage, 
may  be  a  valuable  adjunct  to  psycho-therapeutic  meas- 
ures but  can  easily  be  overdone.  If  it  tends  to  center 
the  patient's  interest  more  closely  on  his  condition,  it  is 
definitely  bad. 

Suggestion  has  effected  some  sudden  and  dramatic 
cures  and  is  always  a  powerful  aid  in  furnishing  the 
initial  impulse  to  self-control.  A  simple  illustration  is 
the  man  who  insisted  that  his  left  leg  was  completely 
paralyzed.  Asked  about  the  strength  of  his  right  leg, 
he  kicked  out  with  it  strongly,  unconscious  that  he  was 
at  the  time  standing  on  his  left.  Similarly,  men  who 
have  lost  their  power  of  speech  have  found  it  when 
physically  hurt  or  through  suddenly  joining  in  the  well- 
known  chorus  of  a  song.  Suggestion  cures  are,  however, 
not  always  permanent,  for  while  the  fixed  idea  may  be 
dissipated,  the  state  of  mind  which  made  it  possible 
remains.  This  must  be  changed  by  longer  treatment. 
The  affected  muscle  groups  must  also  be  systematically 
re-educated  before  the  cure  is  complete.  The  case  of  a 
Canadian  soldier  suffering  from  paraplegia  is  interesting 
both  for  the  psychic  cause  of  his  trouble  and  for  the 
way  in  which  he  was  cured.  The  man  in  question  re- 
ceived a  slight  wound  and  a  severe  shock  from  the 
explosion  of  a  shell  which  blew  in  the  wall  of  the  trench 
where  he  was  standing.  The  wound  healed  rapidly,  but 
the  purely  functional  paraplegia  persisted  with  great 
stubbornness.  On  being  questioned,  the  man  said  that 
he  had  seen  a  companion  have  both  legs  blown  off;  later 


158  THE      DISABLED      SOLDIER 

he  admitted  that  he  had  a  sister  unable  to  walk  and 
that  he  had  dreaded  receiving  an  injury  which  would 
make  another  helpless  invalid  in  the  family.  In  the 
endeavor  to  prove  to  him  that  his  fears  were  unfounded, 
the  doctors  anesthetized  him  and  while  he  was  uncon- 
scious raised  his  legs  in  front  of  him  with  bent  knees. 
When  he  came  out  of  the  anesthetic,  he  was  told  that 
he  had  himself  raised  his  knees  and  was  ordered  to  lower 
them  into  a  more  convenient  position.  The  result  was 
a  distinct  movement  of  the  muscles.  From  this  time  the 
man  knew  that  his  muscles  were  not  lifeless,  and  through 
graduated,  continued  practice  he  finally  regained  com- 
plete control. 

Since  the  main  factor  in  the  cure  of  any  functional 
nervous  disease  is  the  will  of  the  patient,  everything 
must  be  done  to  make  life  seem  worth  while  to  him. 
Games  and  gentle  sports  in  the  op>en  air  are  beneficial, 
but  better  than  anything  else  is  some  light  interesting 
work.  Almost  any  kind  of  work  will  serve  the  purpose 
if  it  is  not  too  fatiguing  or  so  monotonous  that  it  becomes 
mechanical.  Creative  work  with  the  fingers  is  usually 
attractive  to  nervous  patients.  If  it  is  in  addition  work 
in  which  they  can  progress  by  definite  steps,  always 
conscious  of  their  own  improvement,  it  seldom  fails  to 
have  an  excellent  effect  upon  both  their  spirits  and  their 
bodies.  After  a  few  weeks  or  even  days  of  some  con- 
genial occupation,  men  begin  to  take  a  new  interest  in 
life.  Their  eyes  brighten;  their  limbs  stop  trembling; 
they  are  no  longer  racked  by  dreams.  With  the  awaken- 
ing of  their  interest  their  will  and  initiative  are  also 
aroused,  and  their  cure  then  is  not  far  off. 

Various  occupations  have  been  introduced  into  the 
hospitals  and  convalescent  homes  of  our  allies  as  a  means 


BRINK      OF      THE      CHASM  159 

of  refitting  nervously  shattered  men  for  the  business  of 
life.  At  the  Central  Hospital  for  Nervous  Diseases  at 
Cobourg,  Ontario,  to  which  are  sent  the  severer  shock 
cases  among  the  Canadian  returned  soldiers,  patients  are 
started  at  some  simple  occupational  work  such  as  bas- 
ketry or  clay  modeling;  as  they  become  capable  of 
greater  effort,  they  are  directed  to  carpentry,  pottery, 
or  gardening.  At  Golders  Green  in  London,  the  first 
Home  of  Recovery  for  discharged  soldiers  unable  to 
earn  a  living  because  of  their  nervous  condition,  great 
emphasis  is  placed  on  intensive  garden  culture.  French 
methods  are  used — cold  frames,  cloches,  heavy  fertilizing, 
and  other  means  of  forcing — and  a  surprising  number  of 
vegetables  are  produced  on  a  small  plot  of  ground.  It 
is  hoped  that  the  work  will  not  only  serve  a  remedial 
purpose,  but  that  it  will  provide  a  livelihood  later  to 
men  who  can  never  make  a  complete  recovery.  In  con- 
nection with  the  garden  culture,  there  are  operated 
carpentry,  ironworking,  and  basketry  shops  for  making 
the  glass  frames,  packing  crates,  tools,  and  containers. 
Other  shops  are  for  motor  mechanics,  electric  fitting, 
and  shoemaking. 

Most  of  the  occupational  work  for  men  disabled  by 
shell  shock  has  value  as  a  therapeutic  measure  rather 
than  as  trade  training.  Its  object  is  the  restoration  of 
the  men's  health,  not  their  re-education.  When  they 
are  recovered,  they  are  expected  to  return  to  their  former 
occupation.  If  after  being  cured  of  their  nervous 
troubles  they  are  still  unable  to  take  up  their  old  calling, 
they  must  go  elsewhere  for  serious  training  in  a  new 
trade. 


160  THE      DISABLED      SOLDIER 

CHAPTER  XIII 

ALLIES  ON  THE  CONTINENT 

When  the  call  to  war  broke  in  upon  the  serenity  of 
France,  most  of  the  able-bodied  population  sprang  to 
the  colors — with  the  result  that  we  now  know  so  well. 
There  was  no  provision  then  for  the  training  of  cripples, 
but  as  men  began  to  return  disabled,  an  organization  for 
their  re-education  was  hastily  built  up  to  meet  the  neces- 
sities of  the  situation. 

What  respect  we  must  have  for  the  work  done  in 
France!  With  her  national  existence  threatened,  with 
a  powerful  enemy  not  far  from  the  gates  of  Paris,  that 
gallant  country  with  which  the  United  States  is  now 
proud  to  be  allied,  gave  careful  thought  to  the  future 
of  the  men  injured  in  her  defense.  And  in  spite  of  the 
difficulties,  that  work  for  disabled  soldiers  was  S9  credit- 
able and  SO  imbued  with  sound  spirit  as  to  serve  for 
example  and  inspiration  to  the  world. 

The  enterprise  which  prompted  the  foundation  of  the 
Lyons  school,  as  already  described,  was  not  unique.  A 
similar  spirit  prevailed  in  the  foundation  of  scores  of 
similar  schools  throughout  the  republic.  The  men  who 
founded  them  were  all  pioneers,  working  it  is  true  on  a 
common  problem,  but  each  almost  on  original  lines.  We 
may  properly  expect,  therefore,  that  French  experience 
will  show  much  to  follow  and  much  to  avoid — the  one 
as  helpful  as  the  other. 

In  almost  every  community  in  France,  as  men  dis- 
charged  from   the   army   because   of  their   disabilities 


ALLIES      ON      THE      CONTINENT         161 

began  to  return  to  their  homes,  societies  were  formed 
for  the  purpose  of  organizing  some  system  of  aid  to  the 
broken  and  often  destitute  soldiers.  These  various  soci- 
eties and  committees  throughout  France  soon  recognized 
that  the  Lyons  committee  headed  by  Mayor  Herriot  had 
found  the  best  way  for  really  aiding  disabled  men — a 
far  better  way  than  giving  them  money  allowances  or 
placing  them  in  the  trifling  jobs  open  to  untrained, 
handicapped  men.  The  committees  in  the  larger  cities, 
which  were  able  to  collect  the  necessary  funds,  took 
steps  therefore  to  open  similar  schools  in  their  communi- 
ties. In  Montpellier,  Bourges,  Saint-£tienne,  Bordeaux, 
Rouen,  Toulouse,  Marseilles,  Pau,  and  many  other  cities 
schools  were  organized  during  the  first  eighteen  months 
of  the  war.  The  expense  of  the  undertaking  was  in  most 
cases  originally  borne  by  private  subscriptions,  but  as 
the  value  of  the  work  became  generally  recognized,  the 
municipal  or  departmental  government  assigned  funds 
for  its  support,  and  in  course  of  time  the  school  usually 
passed  under  the  control  of  one  of  these  administrations. 
The  first  re-educational  school  to  be  established  and 
maintained  by  the  national  government  was  opened  at 
Saint-Maurice,  a  suburb  of  Paris,  in  May  of  1915.  The 
government  took  over  for  this  purpose  a  group  of  build- 
ings which  had  been  used  as  a  public  convalescent  home 
and  a  home  for  industrial  cripples.  It  installed  here  not 
only  a  finely  equipped  trade  school  with  dormitories 
and  workshops  but  also  a  military  hospital  in  which  a 
certain  number  of  beds  were  reserved  for  men  who 
wished  to  take  courses  in  the  school.  By  this  arrange- 
ment hospital  treatment  and  trade  training  were  dove- 
tailed ;  that  is,  men  were  enabled  to  start  their  occupa- 
tional  work   before    the   completion    of   their   hospital 


162  THE      DISABLED      SOLDIER 

treatment.  Most  of  the  provincial  schools  had  no  such 
hospital  connection,  nor  did  they  at  first  desire  it,  being 
of  the  opinion  that  a  man  should  be  thoroughly  cured 
of  his  wounds  before  he  attempted  any  kind  of  work. 
After  two  years  of  experience,  however,  the  value  of  co- 
operation between  hospital  and  school  was  apparent,  and 
the  government  took  measures  to  attach  the  existing 
schools  to  military  hospitals  in  the  vicinity  and  to-  or- 
ganize new  schools  wherever  there  were  no  re-educational 
facilities  within  the  reach  of  convalescent  patients.  It 
is  now  an  accepted  principle  with  French  authorities 
that  every  man,  before  he  is  discharged  from  hospital, 
should  have  the  opportunity  to  take  up  some  form  of 
training  for  self-support. 

The  schools  have  found  their  usefulness  greatly  in- 
creased by  this  arrangement,  for  it  has  enabled  them  to 
recruit  more  pupils  and  to  obtain  better  and  quicker 
results.  Patients  in  a  hospital,  with  the  example  of  their 
comrades  before  them,  can  be  more  easily  induced  to 
enter  upon  a  course  of  training  than  men  who  have  re- 
turned to  their  homes  and  been  already  a  little  spoiled 
by  the  hero-worship  of  their  friends  and  families.  Work 
begun  as  early  as  possible  in  the  convalescent  period 
is,  moreover,  an  excellent  preventive  of  that  malady 
sometimes  known  as  hospitalitis,  which  so  insidiously 
attacks  the  will  and  ambition  of  long-term  patients. 
The  saving  of  time  to  the  men  themselves  is  of  course 
invaluable. 

Some  of  the  societies  organized  in  Paris  to  render  aid 
to  the  returned  soldiers  have  acquired  a  nation-wide 
membership  and  through  powerful  public  appeals  have 
been  able  to  raise  large  sums  for  their  purpose.  Part 
of  their  resources  have  been  devoted   to  establishing 


ALLIES      ON      THE      CONTINENT         163 

employment  agencies  and  to  furnishing  better  artificial 
limbs,  but  more  and  more  of  their  energies  are  being 
turned  toward  providing  opportunities  for  re-education. 
This  they  have  done  in  general  through  financial  aid  to 
schools  started  by  others,  though  wherever  they  have 
perceived  the  need  they  have  created  new  schools.  They 
have  also  placed  large  numbers  of  men  as  apprentices 
with  private  employers. 

An  interest  in  the  future  of  French  industry,  joined  to 
an  earnest  desire  to  help  the  glorious  mutiles,  has  in- 
fluenced other  groups  to  take  up  the  work  of  refitting 
injured  men  to  be  productive  wage-earners.  Those 
trade  unions  which  already  possessed  facilities  for  train- 
ing apprentices  in  their  craft  have  opened  the  doors  of 
their  schools  to  returned  soldiers,  while  others  have 
organized  teaching  workrooms  and  conduct  large  classes 
of  the  disabled.  Employers  large  and  small  have  shown 
their  eagerness  to  cooperate  in  this  work.  Many  have 
of)ened  their  shops  to  learners  on  favorable  terms,  and 
others  have  formed  schools  in  which  they  provide  in- 
struction in  the  various  trades  used  in  their  shops.  The 
national  schools  which  before  the  war  gave  special 
training  in  business,  the  skilled  crafts,  or  agriculture 
have  organized  new  courses  for  the  disabled.  These 
courses  are  shorter  and  necessarily  less  complete  than 
the  regular  courses  for  young  apprentices,  but  they 
enable  disabled  men  to  acquire  sufficient  working  knowl- 
edge of  the  trade  to  obtain  employment  in  it. 

Since  a  majority  of  the  wounded  poilus  are  peasants 
whose  homes  are  in  tiny  villages  far  from  factories  and 
shops,  it  has  been  necessary  for  most  of  the  schools  to 
teach  simple  village  trades.  The  movement  cityward 
has  to  be  combated  in  France  for  the  sake  of  the  nation's 


164  THE      DISABLED      SOLDIER 

future  prosperity,  and  schools  have  therefore  had  to 
guard  against  teaching  trades  which  would  take  men 
away  from  their  homes  on  the  land  and  concentrate 
them  in  industrial  centers..  The  peasant  who  can  no 
longer  follow  the  plow  or  swing  the  scythe  must  not  be 
uprooted  from  his  old  surroundings,  but  must  be  taught 
a  trade  in  which  he  can  earn  a  living  for  himself  and  his 
family  in  the  old  neighborhood.  Almost  every  French 
village  can  use  a  tailor  or  a  shoemaker,  usually  a  saddler 
and  harness-maker,  too,  and  a  basket-maker  who  can 
supply  the  particular  kind  of  container  used  for  the 
local  products.  There  are  also  always  pots  and  pans 
to  be  mended — a  tinsmith  is  needed  for  that — and  there 
are  countless  calls  for  a  carpenter.  These  then  are  the 
trades  most  frequently  taught  in  the  provincial  schools. 
Of  them  all  the  most  popular  with  the  men  is  shoe- 
making.  In  practically  every  school  throughout  the 
country  one  finds  more  pupils  in  the  shoemaking  section 
than  in  any  other  manual  trade.  In  explanation  of  this 
fact  one  of  the  most  successful  re-educators  in  France 
has  written  that  the  men  are  attracted  by  the  prospect 
of  being  able  to  set  up  their  shop  in  their  own  house,  so 
that  between  nailing  on  new  soles  they  can  run  out  and 
hoe  their  potatoes  or  cultivate  a  few  grapes.  In  many 
parts  of  the  country  where  the  peasants  wear  wooden 
sabots  or  the  clogs  with  wooden  soles  and  cloth  uppers 
known  as  galoches,  sabot  and  galoche-making  share  the 
honors  with  shoemaking.  Tailoring  does  not  attract  the 
returned  soldier,  and  though  there  is  a  demand  for  good 
workmen  in  the  trade  many  schools  are  giving  up  their 
classes.  All  of  these  trades  with  the  exception  of  car- 
pentry have  been  found  within  the  capacities  of  men 
with  leg  amputations  and  have  in  some  instances  been 


A  New  Way  to  Sharpen  a  Scythe.     With  two  arms  gone  and 
one  eye  missing,  this  French  poilu  can  earn  his  living 


1 


ja  -2 


ALLIES      ON      THE      CONTINENT         165 

mastered  by  men  with  lesser  arm  injuries.  A  carpenter 
with  a  leg  amputated  can  do  bench  work  but  cannot 
mount  scaffoldings.  Since  carpentry  is,  however,  always 
an  arduous  trade  and  beyond  the  strength  of  many 
wounded  men,  it  has  been  replaced  in  many  schools  by 
cabinet-making. 

Favorite  courses  with  men  who  wish  to  practise  a 
trade  in  the  city  are  those  which  make  them  mechanics 
and  machinists.  Peasants  with  a  mechanical  turn  have 
opportunities  to  become  farm  mechanics,  or  men  quali- 
fied to  operate  and  repair  tractors  and  other  agricultural 
machinery.  In  the  old  days  there  would  have  been  little 
enough  demand  in  the  French  countryside  for  skill  of 
this  sort,  but  the  war  has  changed  all  things,  even  the 
unchanging  methods  of  the  French  farmer,  and  now  in 
an  effort  to  replace  the  labor  of  the  peasant  lads  who 
have  died  on  the  battle  line,  an  increasing  number  of 
tractors  are  being  imported  from  America  and  put  to 
work  upon  the  fallow  fields.  The  schools  teach  men  not 
only  to  operate  them  but  also  to  repair  them  and  even 
to  replace  parts  upon  the  forge  or  lathe,  for  many  ma- 
chines will  go  into  remote  districts  where  they  have 
never  been  seen  before. 

A  large  number  of  men  who  before  the  war  worked 
in  the  wood,  leather,  or  metal  trades  are  being  trained 
to  make  artificial  limbs.  This  is  a  growing  industry  in 
France,  and  the  need  for  skilled  workmen  is  acute.  Two 
good  hands  are  as  a  rule  required  for  it,  but  the  loss  of 
a  leg  need  not  be  a  handicap.  Indeed,  it  may  even  be 
an  asset,  for  who  is  so  well  fitted  to  improve  old  models 
or  to  make  new  inventions  as  the  man  who  is  conscious 
of  the  defects  of  his  own  artificial  leg?  Disabled  French 
soldiers  working  in  school  shops  have  devised   many 


166  THE      DISABLED      SOLDIER 

useful  appliances  and  are  now  turning  out  large  quanti- 
ties of  limbs  for  their  wounded  comrades. 

Toy-making  has  been  selected  as  a  good  trade  to  teach 
disabled  soldiers  for  two  reasons — because  there  is  a 
general  wish  to  see  an  industry  formerly  monopolized  by 
the  Germans  built  up  in  France  and  because  it  contains 
openings  for  one-armed  men.  At  the  £cole  Joffre  in 
Lyons  one-armed  men  cut  out  the  flat  toys  by  means  of 
a  band  saw,  turn  others  in  the  round  at  a  lathe,  and 
paint  the  droll  faces  and  quamt  costumes  which  make 
French  toys  a  delight  to  old  as  well  as  young. 

One-armed  men  are  also  employed  at  the  Ecole  Jofifre 
in  making  paper  boxes  and  paper  bindings.  Some  proc- 
esses in  bookbinding  are  beyond  their  powers,  but  they 
can  do  all  the  work  on  notebooks,  pads,  and  ledgers. 
They  do  not  work  as  quickly  as  other  men,  but  by 
specializing  at  one  machine  they  can  acquire  sufficient 
proficiency  to  earn  a  fair  wage.  The  school  hopes  to 
place  many  of  them  as  foremen  or  examiners,  positions 
which  do  not  require  constant  manual  effort. 

Work  with  a  lathe  or  band  saw,  in  the  experience  of 
several  schools,  yields  a  good  return  to  men  who  have 
lost  an  arm.  French  varnishing  has  also  been  found  to 
be  suited  to  them.  Pottery  is  another  possible  trade 
for  men  so  handicapped.  There  are  innumerable  seated 
trades  in  which  men  with  leg  injuries  can  do  a  full  day's 
work,  but  there  are  comparatively  few  in  which  the 
one-armed  can  compete  with  uninjured  employees. 

Since  so  many  of  the  manual  trades  are  closed  to 
them,  the  majority  of  the  one-armed  in  French  schools 
are  being  trained  for  office  positions.  They  are  taught 
bookkeeping  and  business  usage,  stenography  and  type- 
writing,   and    afterwards    placed    in    banks,    business 


ALLIES      ON      THE      CONTINENT         167 

houses,  and  government  offices.  Often  common  school 
subjects,  such  as  writing,  French  composition,  arith- 
metic, and  geography,  are  included  in  the  course,  in 
order  to  supply  the  deficiencies  of  the  soldier's  previous 
education  or  to  brush  up  long-forgotten  learning.  Some 
general  schooling  is  also  given  to  the  men  learning  trades, 
usually  for  an  hour  after  dinner  in  the  evening. 

Another  kind  of  office  work  in  which  badly  disabled 
men  have  achieved  real  success  in  France  is  industrial 
design  or  drafting.  Men  who  have  lost  the  use  of  one 
arm,  even  those  who  have  suffered  amputation  of  the 
arm,  have  been  able  to  acquire  skill  in  the  work  and 
afterwards  to  obtain  good  positions  as  tracers  or  de- 
tailers.  Many  of  these  have  had  no  previous  training 
in  work  of  the  kind,  often  no  technical  background  at 
all,  though  machinists  and  men  in  the  building  trades 
incapable  of  the  activity  and  strength  required  in  their 
old  work  have  found  it  particularly  interesting.  In 
schools  where  the  draughting  course  has  been  most  suc- 
cessfully developed,  several  branches  of  design  are 
taught,  so  that  a  pupil  can  specialize  in  that  for  which 
he  has  most  talent.  In  the  municipal  school  for  disabled 
soldiers  at  Paris,  for  instance,  the  course  includes 
draughting  for  machinery,  building  construction,  furni- 
ture, architecture,  and  landscape  gardening. 

Sometimes  twenty  or  more  different  trades  are  taught 
in  one  school  in  order  to  meet  the  needs  of  men  with  all 
sorts  of  different  injuries  and  from  many  different  locali- 
ties. Such  a  variety  of  opportunity  is  to  be  found  in 
the  larger  schools  of  Paris  and  Bordeaux,  where  from 
two  to  three  hundred  pupils  can  be  cared  for  at  one 
time.  There  are,  however,  a  number  of  smaller  schools, 
situated  in  regions  where  there  is  a  predominant  local 


168  THE      DISABLED      SOLDIER 

industry,  which  teach  only  the  one  trade.  Thus  at 
Saint-Claude,  a  small  city  in  the  Jura  which  is  the  center 
of  the  diamond-cutting  industry  of  France,  the  school 
organized  by  the  townspeople  for  disabled  soldiers 
teaches  nothing  but  diamond-cutting.  The  school  at 
Oyonnax  teaches  only  the  different  branches  of  the 
celluloid  industry,  thereby  fitting  men  to  go  into  the 
numerous  celluloid  factories  in  the  vicinity.  The  na- 
tional school  of  clock-making  at  Cluses  near  the  Swiss 
border  is  adding  to  the  number  of  renowned  clock  and 
watch-makers  of  that  region.  In  Paris  there  are  special 
schools  for  novelty  jewelry-making,  glass-blowing,  tapes- 
try-weaving. 

In  the  early  days  of  the  re-education  movement,  when 
schools  to  teach  new  trades  to  the  disabled  were  springing 
up  all  over  the  country,  the  importance  of  training  for 
the  farm  was  not  sufficiently  recognized.  A  few  schools 
taught  truck  gardening  with  perhaps  poultry  or  rabbit 
raising,  but  there  was  no  thorough-going  effort  to  induce 
the  wounded  farmer  to  go  back  to  his  old  useful  work  of 
producing  wheat  or  milk  or  sugar  beets  to  feed  the  nation. 
When  it  was  seen,  however,  that  the  shortage  of  farm 
labor  was  one  of  the  most  serious  problems  facing  the 
country,  the  need  was  clear  for  training  which  would 
enable  a  disabled  man  to  work  on  a  farm  and  to  profit 
from  owning  a  farm.  This  training  is  now  being  pro- 
vided by  the  Minister  of  Agriculture  in  the  existing 
agricultural  schools  and  by  some  private  associations  in 
newly  .organized  farm  schools.  An  agricultural  school 
for  French  mutiles  is  also  being  conducted  by  the  Ameri- 
can Red  Cross,  which  has  recognized  the  urgent  need  of 
fitting  the  wounded  to  return  to  the  land. 


ALLIES      ON      THE      CONTINENT  169 

The  first  purpose  of  the  instruction  given  is  to  show 
the  unhappy,  often  hopeless  farmer  that  he  is  still  cap- 
able of  hard  outdoor  work.  Practice  in  the  management 
of  his  artificial  limb  and  in  new  ways  of  handling  his 
old  tools  will  do  this  for  him  and  at  the  same  time  give 
him  back  his  courage  and  revive  his  old  interests.  Some 
men  go  back  to  their  homes  after  these  first  few  weeks 
of  readaptation,  but  others  are  persuaded  to  stay  for  a 
longer  period.  They  are  then  taught  modern  methods 
of  general  farming,  including  scientific  fertilizing,  the 
prevention  of  pests,  and  the  use  of  labor-saving  machin- 
ery, or  they  take  up  the  study  of  some  branch  of  farming, 
such  as  butter  and  cheese  making,  sheep  raising,  or  bee 
keeping.  It  is  hoped  that  after  this  instruction  men 
who  before  the  war  were  but  farm  hands  will  have  the 
requisite  knowledge  for  managing  a  small  farm  of  their 
own.  The  means  of  acquiring  a  small  piece  of  land  have 
been  put  within  their  reach  by  the  recent  passage  of  a 
law  which  enables  disabled  soldiers  to  borrow  money 
from  the  agricultural  banks  at  a  very  low  rate  of  interest 
for  the  purpose  of  buying  or  improving  agricultural 
property.  The  sum  is  small,  being  limited  to  ten  thou- 
sand francs,  but  holdings  are  also  small  in  France,  and 
much  can  be  raised  on  them  by  the  intensive  industry 
of  the  French  farmer.  Returned  soldiers  who  are  already 
proprietors  will  perhaps  derive  even  greater  benefit  from 
the  law,  in  that  they  will  be  able  to  re-stock  their  farms 
and  buy  new  machinery,  and  so  begin  their  new  life 
with  perhaps  a  fairer  start  than  before. 

Mayor  Herriot  of  Lyons — to  whom  can  be  attributed 
so  much  that  is  good  in  the  French  measures  for  the 
disabled — decided  to  provide  free  board  and  lodging  for 
his  pupils  while  they  were  learning  their  new  trades,  and 


170 THE      DISABLED      SOLDIER 

most  of  the  other  schools  followed  his  example.  The 
re-education  school  in  France  is  therefore  usually  a 
boarding-school  with  dormitories  and  dining-halls  as 
well  as  classrooms  and  shops.  Whether  trade  training 
given  under  these  conditions  would  appeal  to  our  soldiers 
on  their  return  from  overseas  is  open  to  discussion,  but 
the  system  is  apparently  admirably  suited  to  the  necessi- 
ties and  disposition  of  the  French  inutile.  By  living  in 
the  boarding-school  the  pupil  from  outside  the  city 
enjoys  cleaner  quarters  and  a  better  chosen  diet  than 
he  could  obtain  in  the  usual  working-man's  boarding- 
house;  he  is  less  tempted  to  cut  his  classes  or  his  shop 
work;  and  he  comes  into  closer  relations  with  his  in- 
structors. These  through  their  more  intimate  acquaint- 
ance with  his  problems  are  better  able  to  help  him  over 
the  difficulties  and  discouragements  which  are  bound  to 
beset  him  during  the  early  period  of  his  training. 

The  discipline  in  the  schools,  though  not  military,  is 
fairly  strict,  but  the  pupils  seem  to  submit  to  it  with 
entire  good  grace.  They  are  usually  required  to  wear 
a  special  uniform  and  they  are  in  many  places  allowed 
to  leave  the  grounds  only  on  Sundays  and  the  Thursday 
half-holidays.  If  a  pupil  breaks  the  rules,  he  may  be 
warned  and  deprived  of  his  leaves,  but  if  he  continues 
to  show  a  bad  spirit,  he  is  simply  sent  away  from  the 
institution.  The  authorities  want  only  sober,  indus- 
trious men  who  will  make  the  most  of  the  opportunities 
offered  to  them.  A  man  who  imagines  that  he  is  there 
for  anything  but  work  soon  finds  that  his  place  is  needed 
for  some  more  earnest  pupil. 

While  the  boarding-school  principle  generally  prevails 
in  France,  there  are  numerous  day  schools,  the  guild 
schools  in  Paris  for  instance,  which  have  been  very  sue- 


ALLIES      ON      THE      CONTINENT  171 

cessful  in  their  teaching,  and  there  has  been  some  use  of 
the  apprenticeship  system.  The  apprenticeship  system 
trains  men  by  placing  them  as  learners  in  shops  and  fac- 
tories. It  has  some  obvious  advantages  over  the  school 
method — it  is  more  economical  in  that  new  workshops 
do  not  have  to  be  fitted  out;  it  offers  the  choice  of  an 
almost  infinite  variety  of  trades;  and  it  allows  the  men 
to  work  and  live  under  more  normal  conditions — but 
there  is  always  danger  that  the  instruction  will  not  be 
so  good.  Too  often  an  apprentice  is  treated  simply  as 
cheap  labor  and  gets  no  chance  to  learn  the  different 
processes  of  the  trade.  At  Tours,  however,  where  the 
system  has  been  put  into  practice  rather  more  exten- 
sively than  elsewhere  in  France,  it  has  had  excellent 
results.  The  director  of  the  work  at  Tours,  a  citizen 
who  gives  his  time,  is  a  man  of  rare  judgment  in  placing 
men  and  of  untiring  devotion  in  watching  over  their 
progress,  by  force  of  which  qualities  he  has  been  able  to 
overcome  many  of  the  usual  obstacles  to  successful  ap- 
prenticeship. Other  dangers  which  everywhere  lie  in 
wait  for  the  disabled  man  when  he  is  first  thrown  on  his 
own  resources — discouragement,  gambling,  and  drunken- 
ness— have  been  guarded  against  at  Tours  by  housing 
and  boarding  together  all  apprentices  without  homes  in 
the  city.  Many  of  the  advantages  of  the  boarding-school 
are  in  this  way  secured  to  the  men,  and  there  can  be 
some  supervision  over  their  habits  and  leisure  hours. 

In  a  boarding-school  men  receive  their  living  and  often 
their  clothing  and  laundry  as  well  as  their  instruction 
without  cost  to  themselves.  If  they  attend  a  day  school, 
they  receive  from  some  aid  society  a  small  allowance, 
three  or  four  francs  a  day,  which  is  expected  to  provide 
them  with  the  necessities  of  life.    In  addition,  most  of  the 


172  THE      DISABLED      SOLDIER 

schools  pay  their  pupils  wages,  a  small  sum  at  the  begin- 
ning, which  increases  as  the  man's  skill  increases.  Often 
these  wages  are  paid  out  of  the  proceeds  of  the  sale  of 
the  articles  made  by  the  pupils,  the  sum  being  divided 
among  them  in  proportion  to  what  they  have  done.  At 
least  a  part  of  the  money  thus  earned  the  men  are  ex- 
pected to  save  so  that  they  will  have  the  wherewithal 
to  buy  the  tools  and  equipment  they  will  need  when 
they  set  up  for  themselves.  The  family  of  a  man  in 
training  has  either  his  pension,  which  is  never  touched 
by  the  school,  or  the  separation  allowance  which  they 
received  while  he  was  in  the  army. 

As  has  been  said,  the  chief  re-educational  schools  of 
France,  with  the  exception  of  the  national  institute  at 
Saint-Maurice,  were  originally  financed  by  subscriptions 
from  individuals  plus  grants  of  money  from  the  city  or 
department  in  which  they  were  located.  Later,  as  the 
very  great  national  importance  of  their  work  was  recog- 
nized, most  of  the  schools  received  financial  aid  from 
the  national  government,  submitting  at  the  same  time 
to  government  inspection.  It  then  became  apparent 
that  there  should  be  some  government  department  which 
could  efficiently  oversee  the  work  of  the  schools,  co- 
ordinate their  efforts,  and  work  out  a  uniform  system  of 
re-education  for  the  whole  country.  A  bureau  known 
as  the  National  Office  for  discharged  and  disabled  sol- 
diers was  accordingly  created,  with  headquarters  at 
Paris  and  branch  offices  or  committees  in  each  of  the 
eighty  odd  departments,  or  administrative  districts  of 
France.  It  is  the  duty  of  the  departmental  or  local  com- 
mittees to  see  that  every  returned  soldier  gets  what  he 
needs  in  training  or  employment;  if  facilities  are  inade- 
quate, then  these  committees  should  see  that  the  needed 


ALLIES      ON      THE      CONTINENT         173 

classes  or  schools  or  employment  agencies  are  organized. 
The  National  Office  itself  is  charged  with  giving  a  com- 
mon direction  to  the  work  and  with  seeing  that  the  best 
interests  of  the  mutiles  are  in  every  way  served. 

Good  jobs  are  easily  found  in  France  for  disabled  men 
who  have  been  re-trained  for  work.  In  fact,  most  of  the 
graduates  from  the  French  schools  have  secured  better 
positions  than  they  had  before  the  war.  They  have 
usually  obtained  their  positions  through  the  school 
where  they  trained,  or,  if  the  school  did  not  undertake 
any  placement  work,  through  the  local  employment 
office  for  discharged  soldiers.  A  great  many  employ- 
ment bureaus  for  discharged  soldiers  were  opened  by 
unofficial  aid  associations  during  the  first  months  of  the 
war,  but  the  work  has  now  been  mainly  taken  over  by 
government  bureaus  under  the  control  of  the  Minister 
of  Labor.  Local  offices  are  now  to  be  found  in  every  city 
and  town ;  exchange  agencies  for  these  are  located  in  the 
prefectures,  or  capital  cities  of  the  departments;  and 
there  is  at  Paris  a  clearing-house  for  all  the  agencies  in 
the  country.  All  agencies  have  been  instructed  that 
they  should  whenever  possible  settle  men  in  the  district 
in  which  they  lived  before  the  war  and  either  in  their 
old  trade  or  in  an  occupation  closely  connected  with  it. 
They  have  also  been  warned  to  make  sure  that  the  situ- 
ations they  offer  are  suitable  ones  for  handicapped  and 
often  sadly  shattered  men.  The  industry  in  which  a  dis- 
abled man  is  placed  should  not  be  one  with  a  slack 
season  when  the  least  efficient  workers  will  be  laid  off, 
and  the  working  and  living  conditions  should  be  good. 
Above  all,  the  individual  should  be  really  fitted  for  the 
position.  There  should  be  no  placing  of  men  in  the  first 
position  that  happens  to  turn  up  in  the  idea  that  the 


174 THE      DISABLED      SOLDIER 

employer's  patriotism  will  make  up  for  the  workman's 
incapacity.  These  are  surely  sound  principles  and 
should  be  at  the  basis  of  all  placement  work  for  disabled 
soldiers. 

A  very  natural  tendency  on  the  part  of  employers  to 
discriminate  against  disabled  men  because  of  the  in- 
creased cost  of  workmen's  compensation  insurance  when 
numbers  of  disabled  are  employed  has  been  overcome 
by  the  passage  of  a  new  workmen's  compensation  law. 
This  law  provides  that  if  an  accident  to  a  disabled  soldier 
while  at  work  was  caused  by  his  previous  disability,  the 
compensation  shall  be  paid  not  by  the  employer  but  by 
the  national  government.  And  if  the  man's  incapacity 
for  work  after  the  accident  is  due  in  any  part  to  his  pre- 
vious condition,  only  that  part  of  the  allotted  sum  which 
is  compensation  for  the  direct  results  of  the  accident 
shall  be  paid  by  the  employer,  the  government  being 
responsible  for  the  rest.  The  government's  share  of  the 
compensation  is  to  be  paid  out  of  a  fund  raised  by  a 
tax  on  employers  and  insurance  companies.  Since  acci- 
dent insurance  premiums  will  therefore  not  be  increased 
to  the  employers  of  disabled  men  and  since  employess 
are  taxed  whether  they  employ  the  disabled  or  not,  there 
no  longer  exists  this  ground  for  discrimination. 

Belgian  soldiers  wounded  in  the  terrible  retreat  from 
Liege  to  Dixmude  were  discharged  from  the  hospitals 
in  an  even  more  broken  and  destitute  state  than  their 
French  comrades  in  arms.  Frenchmen,  all  but  those 
from  the  devastated  districts  of  the  north,  had  at  least 
homes  to  which  they  could  return.  Their  lot  was  piti- 
able enough  in  its  helplessness  and  enforced  idleness, 
but  there  was  some  comfort  for  them  in  the  ministrations 
of  their  families  and  friends.    Belgium,  however,  except 


ALLIES      ON      THE      CONTINENT         175 

for  the  narrow  strip  of  sand  and  marsh  behind  the  bloody 
Yser,  was  all  a  devastated  region;  homes  had  been 
sacked  and  burned  by  the  invader,  families  had  been 
slaughtered  and  carried  off  into  captivity.  When  a 
Belgian  was  of  no  more  use  in  the  army,  he  could  be 
discharged,  but  he  could  not  be  sent  home.  He  could 
only  be  turned  adrift  and  left  to  work  or  beg  his  way 
along  French  or  English  roads.  Often  it  happened  that 
before  men's  wounds  were  barely  healed,  the  hospitals 
where  they  lay  were  flooded  by  a  new  tide  of  wounded 
men  from  the  front,  and  all  who  were  able  to  leave  were 
turned  out.  Belgian  soldiers,  therefore,  were  often  unfit 
for  work  because  they  had  not  been  able  to  secure  the 
longer  treatment  which  might  have  restored  to  them  in 
some  measure  the  use  of  injured  joints  and  muscles. 

It  is  said  that  two  of  these  poor  fellows,  their  clothes 
in  tatters,  their  feet  through  their  boots,  but  their 
breasts  covered  with  medals  for  distinguished  bravery 
in  defense  of  their  country,  stopped  at  a  certain  house  in 
Havre  and  asked  for  food.  The  house  was  that  of  the 
president  of  the  Belgian  House  of  Representatives, 
M.  SchoUaert,  who  himself  listened  to  the  men's  stories. 
Shocked  by  the  situation  which  he  was  thus  able  to 
image,  M.  SchoUaert  took  them  in  and  immediately 
applied  to  the  government  for  permission  to  provide  a 
home  and  medical  care  for  these  and  other  destitute 
soldiers.  The  manor-house  at  Sainte-Adresse  in  which 
he  placed  them  and  the  staflf  he  organized  for  their 
physical  reconstruction  became  the  nucleus  of  one  of 
the  two  great  institutions  now  providing  re-education 
for  Belgian  soldiers. 

The  founder  and  director  of  this  DSpot  des  Invalides 
at  Sainte-Adresse  soon  saw  that  he  must  add  vocational 


176  THE      DISABLED      SOLDIER 

training  to  his  program  if  he  was  to  refit  the  men  under 
his  care  for  life  and  work.  Workshops  of  a  primitive 
kind  were  therefore  installed  wherever  there  could  be 
found  a  place  for  them  in  the  neighborhood.  The 
brush-makers  were  set  at  work  in  the  stable,  the  carpen- 
ters in  a  hired  shed,  and  the  shoemakers  in  the  parlor 
of  a  villa.  Later  when  the  Belgian  government  lent  its 
aid  to  the  work,  all  the  shops  and  dormitories  were 
gathered  together  in  portable  wooden  barracks  in  a  vast 
cantonment. 

Before  the  institution  at  Sainte-Adresse  had  passed 
through  more  than  its  earliest  stages,  the  government 
realized  that  the  disabled  soldier  problem  could  only 
be  solved  by  more  far-reaching  measures.  The  first 
action  then  taken  was  the  announcement  by  the  Min- 
ister of  War  that  soldiers  who  were  unable  because  of 
their  wounds  to  perform  their  former  work  would  no 
longer  be  discharged  at  the  end  of  their  hospital  treat- 
ment but  would  be  sent  to  an  institution  where  they 
could  learn  a  new  occupation.  The  next  was  directed 
at  the  men  who  had  been  previously  discharged  and 
who  were  now  in  distress  in  France  and  England.  Agents 
of  the  Belgian  government  rounded  up  these  men,  re- 
voked all  their  discharge  papers,  and  subjected  them  to 
new  physical  examinations.  Those  that  were  found  suf- 
ficiently able-bodied  to  be  of  use  in  the  auxiliary  services 
were  taken  back  into  the  army;  the  others,  unless  they 
had  secured  well-paid,  permanent  employment,  were 
sent  either  to  a  military  hospital  for  further  treatment 
or  to  Sainte-Adresse  for  vocational  work. 

It  was  then  necessary  to  make  the  re-educational 
facilities  of  the  nation — exiled  though  it  was — adequate 
for  training  all  men  in  the  Belgian  army  who  were  or 


ALLIES      ON      THE      CONTINENT         177 

might  become  incapacitated  for  their  former  occupations. 
To  this  end  the  government  made  grants  of  money  to 
the  institution  at  Sainte-Adresse  and  created  the  Belgian 
national  school  for  disabled  soldiers  at  Port-Villez.  Both 
are  on  French  soil:  Sainte-Adresse  just  outside  of  Havre 
and  Port-Villez  about  half  way  between  Paris  and 
Rouen.  The  two  schools  have  a  capacity  for  training 
over  three  thousand  men. 

Men  are  now  sent  to  Sainte-Adresse  or  Port-Villez 
directly  from  the  base  hospitals  at  Rouen.  If  they  need 
re-education,  they  have  no  choice  but  to  take  it.  The 
compulsory  character  thus  given  to  their  training  has 
been  accepted  without  dispute  by  Belgians,  though  in 
other  countries  the  idea  has  always  been  strongly  op- 
posed. Belgians  have  fewer  counter-attractions  in  their 
lives  than  have  other  men.  They  are  more  cut  off  from 
the  past,  and  they  see  no  future  until  the  invader  is 
driven  out.  For  these  reasons,  perhaps,  they  do  not 
rebel  at  being  kept  in  an  institution  and  made  to  learn 
a  trade. 

But  though  training  of  one  kind  or  another  is  com- 
pulsory, the  individual  can  freely  express  his  preference 
for  this  or  that  kind  of  work,  and  whenever  he  is  not 
debarred  by  mental  or  physical  limitations  can  take  up 
the  kind  he  desires.  Often,  however,  a  man  who  is  cut 
off  from  his  old  occupation  can  fix  upon  no  other,  and 
the  school  authorities  must  then  help  him  to  choose. 
In  this  matter  of  choosing  a  trade — which  is,  in  fact, 
one  of  the  most  important  steps  in  the  whole  process 
of  re-education — the  Belgian  schools  follow  a  notably 
good  course.  Every  man  on  his  arrival  undergoes  a 
thorough  physical  examination,  which  determines  what 
kind  of  work  he  is  physically  capable  of  and  from  what 


178  THE      DISABLED      SOLDIER 

he  is  barred.  This  is  followed  by  a  mental  examination 
designed  to  bring  out  the  extent  of  his  previous  schooling 
and  his  general  intelligence.  Next,  he  is  taken  on  an 
informal  tour  of  the  shops,  during  which  he  can  talk 
with  the  workmen  in  the  different  trades  and  discover 
perhaps  some  latent  taste.  The  several  examiners  then 
compare  their  notes  on  the  man's  aptitudes,  talk  over 
the  matter  with  him  very  seriously,  and  finally  place 
him  in  one  of  the  shops.  If  after  a  week's  trial  the  work 
appears  to  be  unsuited  to  him,  his  case  is  opened  again, 
and  a  new  start  is  made. 

Rarely  does  it  happen  that  there  is  no  work  suited 
to  a  man's  tastes  and  capacities,  for  the  Belgian  schools 
teach  a  very  great  variety  of  trades.  The  woodworking 
trades,  the  metal  trades,  the  leather  trades,  all  branches 
of  printing,  various  farming  specialties,  and  numerous 
other  callings — at  Port-Villez,  over  forty  in  all — give 
the  individual  a  wide  field  for  choice. 

In  most  of  the  shops  the  aim  is  to  produce  salable 
articles  as  well  as  to  teach  the  trade,  but  good  teaching 
is  never  sacrificed  for  the  sake  of  production.  Large 
orders,  for  example,  are  filled  for  the  army  supply 
department,  but  whenever  the  foremen  think  it  neces- 
sary to  give  greater  variety  to  the  men's  work,  there  are 
interspersed  private  orders.  No  order  is  accepted  unless 
it  can  be  utilized  for  instruction. 

Good  teaching  is  a  harder  problem  in  the  re-educa- 
tional school  than  in  a  regular  trade  school  owing  to  the 
fact  that  new  pupils  are  arriving  all  the  time  instead 
of  at  the  beginning  of  a  term.  To  overcome  this  diffi- 
culty, the  Belgian  schools  use  an  excellent  system  of 
group  instruction.  Recent  arrivals  in  a  shop  are  put 
together  and  started  at  the  first  processes  of  the  trade 


ALLIES      ON      THE      CONTINENT  179 

under  the  guidance  of  a  more  advanced  workman.  At 
regular  intervals,  since  different  beginners  will  inevitably 
progress  at  different  rates,  they  are  regrouped  according 
to  their  abilities.  In  some  shops  there  is  a  monitor  for 
every  four  workmen. 

As  a  supplement  to  the  practical  work  of  the  shops 
all  the  men  learning  trades  receive  some  theoretical 
instruction.  Through  this  they  learn  the  principles  of 
construction  of  their  tools  and  machines,  the  properties 
and  sources  of  their  raw  materials,  how  to  determine 
the  sale  price  of  their  products,  and  how  to  place  them 
on  the  market.  Wood  and  metal  workers  attend  classes 
in  draughting,  not  to  become  draughtsmen,  but  so  that 
they  may  be  able  to  read  blue  prints.  In  addition, 
every  man  receives  some  general  schooling. 

Commercial  courses  are  given  to  fit  men  for  civil 
service  and  other  office  positions,  and  there  is  a  normal 
course  for  those  who  wish  to  become  teachers. 

After  the  Belgian  government  had  so  amply  provided 
for  the  artisan  and  commercial  classes  among  its  dis- 
abled, it  determined  to  complete  its  duty  by  giving  to 
young  men  whose  professional  studies  had  been  broken 
off  by  the  call  to  arms  an  opportunity  to  continue  their 
education.  Since  a  university,  unlike  a  trade  school,  could 
not  be  created  overnight,  these  young  men  were  sent  to 
Paris,  where  they  are  lodged  and  boarded  at  the  expense 
of  the  Belgian  government  while  they  study  at  the  great 
Paris  schools.  The  instruction  has  in  most  cases  been 
made  a  free  gift  to  them  from  the  schools.  Their  books 
and  instruments  have  been  furnished  by  the  Belgian 
Minister  of  Arts  and  Sciences. 

As  all  men  in  the  Belgian  re-educational  schools  are 
still  nominally  soldiers,  they  receive  besides  their  main- 


180  THE      DISABLED      SOLDIER 

tenance  their  soldiers'  pay,  but  no  pensions.  If  they  are 
productive  workmen,  they  also  receive  wages,  a  part  of 
which  is  saved  for  them  against  their  departure  from 
the  school. 

In  Italy  as  in  the  other  allied  countries  all  aid  for  the 
disabled  soldier  is  based  on  the  new  principle  that  it 
must  be  aid  through  work.  The  old  idea  of  giving  the 
disabled  soldier  a  pension  and  some  soft  government 
post  was  in  1914  still  strong  in  Italy,  where  the  war  of 
the  Risorgimento  had  been  followed  by  much  the  same 
kind  of  pension  legislation  and  veteran  preference  as  our 
Civil  War.  Soldiers  crippled  in  the  struggle  for  Italia 
irredenta  confidently  expected  to  be  treated  as  were 
Garibaldi's  veterans,  and  to  receive  some  comfortable 
sinecure  in  the  postal  or  telegraph  system  or  at  least  in 
the  government  sale  of  salt  or  tobacco.  The  new  idea 
has,  however,  prevailed,  and  in  1918  all  wounded  sol- 
diers in  the  Italian  armies  are  offered  something  better 
than  the  means  of  living  in  idleness,  namely,  the  chance 
to  learn  a  useful  trade. 

The  Italian  law  is  that  all  crippled  soldiers  shall 
remain  in  the  orthopedic  hospitals  until  they  can  profit- 
ably commence  their  re-education.  They  are  then  dis- 
missed from  the  hospital  on  a  month's  leave  and  allowed 
to  visit  their  homes.  At  the  end  of  the  leave,  unless  they 
are  plainly  not  in  need  of  re-education  or  are  too  hope- 
lessly crippled  to  benefit  from  it,  they  must  report  at 
the  nearest  re-educational  school.  They  are  required  to 
stay  in  the  school  only  two  weeks,  not  long  enough  of 
course  to  make  more  than  a  beginning  at  learning  a 
trade,  but  long  enough  to  understand  what  re-education 
is  and  what  benefits  it  holds  out  to  them.    They  can 


ALLIES      ON      THE      CONTINENT         181 

then  make  their  own  decision  as  to  whether  they  wish 
to  continue  or  to  return  to  their  homes. 

The  schools  of  which  the  government  now  makes  use 
in  its  scheme  for  universal  re-education  were  founded 
by  private  means  and  remain  under  the  management  of 
local  committees,  but  are  controlled  and  in  part  sup- 
ported by  the  government.  Thus  in  Italy  as  in  France 
the  work  was  begun  by  private  initiative  and  only  later 
coordinated  into  a  national  system.  Government  con- 
trol is  exerted  through  an  appointed  National  Board  for 
the  Assistance  of  Invalided  Soldiers,  similar  to  the  French 
National  Office.  This  Board  inspects  and  supervises  the 
work  of  the  schools,  grants  charters  to  new  committees, 
and  revokes  the  charters  of  those  that  do  not  come  up 
to  the  standard. 

The  first  local  committee  was  formed  at  Milan,  and 
the  Milan  school  became  the  model  for  others  as  the 
Lyons  school  was  in  France.  Rome,  Florence,  Naples, 
Genoa,  Bologna,  Palermo,  Venice,  and  other  cities  fol- 
lowed suit  as  soon  as  the  growing  interest  in  the  new 
gospel  had  aroused  the  citizens.  In  most  of  the  northern 
provinces  the  formation  of  committees  has  been  spon- 
taneous, but  public  opinion  has  been  slower  in  the  south. 
In  some  regions  the  National  Board  has  been  empowered 
to  call  on  the  Mayors  of  towns  to  organize  schools  for 
district  needs.  It  appears  that  unless  the  re-educational 
facilities  of  the  country  as  a  whole  are  increased,  the 
law  providing  that  all  crippled  soldiers  shall  spend 
at  least  fifteen  days  in  a  school  cannot  be  put  into 
effect. 

The  outward  surroundings  of  the  schools  have  usually 
their  full  share  of  Italy's  gracious  charm.  The  buildings 
are  often   fifteenth  century  palaces  which  have  been 


182  THE      DISABLED      SOLDIER 

donated  to  the  committees,  or  they  are  ancient  convents 
surrounded  by  gardens,  or  stately  public  buildings  front- 
ing on  picturesque  piazzas.  Within,  the  atmosphere  is 
formal  and  institutional.  Hours  for  work  and  recreation 
are  all  carefully  regulated,  and  the  plan  of  work  is  in- 
elastic. Military  discipline  is  enforced.  At  graduation 
there  are  usually  speeches  and  prizes  given  either  by 
the  committee  or  by  interested  citizens  of  the  town,  for 
the  naive  Italian  peasant  has  his  interest  greatly  stimu- 
lated by  such  ceremonies.  Every  man  receives  also  a 
certificate  stating  his  fitness  to  follow  a  trade. 

While  attending  the  school  the  men  are  supported  by 
the  government,  that  is,  the  government  pays  the  school 
a  fixed  sum  for  their  maintenance.  The  government 
also  pays  the  men  their  regular  soldiers'  pay  and  gives 
their  families  the  same  allowances  as  when  the  men  were 
in  active  service.  The  period  of  training  during  which 
the  man  and  his  family  are  thus  supported  is  limited  to 
six  months,  but  the  National  Board,  if  it  wishes,  can  keep 
the  man  longer  at  the  school  at  its  own  expense. 

The  courses  in  the  Italian  schools  have  been  deter- 
mined largely  by  the  needs  and  limitations  of  the  pupils. 
Eighty  per  cent,  of  the  invalided  soldiers,  ninety  per 
cent,  in  some  provinces,  are  peasants  with  no  experience 
in  trades  and  very  often  illiterate.  The  great  oppor- 
tunity of  the  schools  therefore  has  been  to  give  these 
men  a  rudimentary  education  and  in  so  doing  to  open 
up  to  them  a  new  world.  In  many  of  the  schools  men 
are  allowed  to  take  up  trade  or  business  training  only 
after  they  have  completed  the  elementary  and  inter- 
mediate school  courses.  The  business  courses  train  the 
less  intelligent  among  the  pupils  to  fill  such  simple  posi- 
tions as  concierge  or  store  clerk;  men  capable  of  more, 


ALLIES      ON      THE      CONTINENT         183 

they  fit  to  be  stenographers,  bookkeepers,  and  bank  and 
office  clerks.  There  are  special  courses  for  postal  and 
telegraph  employees  which  are  very  popular  with  the 
men  since  they  lead  to  government  positions,  but  open- 
ings in  this  direction  are  rapidly  being  filled,  and  a  strong 
effort  is  now  being  made  to  divert  men  to  the  trades  and 
to  agriculture. 

The  trades  taught  at  Milan  are  carpentry,  tailoring, 
shoemaking,  basketry,  leather  work,  wood  inlay  and 
wood  carving,  the  making  of  wooden  shoes,  saddlery, 
broom  and  brush  making,  and  mechanics.  In  general 
the  same  trades  are  taught  at  the  other  institutions, 
although  critics  have  pointed  out  that  training  which  is 
profitable  at  Milan,  an  industrial  center,  is  little  suited 
to  the  rural  southern  provinces.  Not  even  a  tailor  or 
a  shoemaker  is  greatly  in  demand  in  primitive  villages 
where  the  inhabitants  go  ragged  and  barefoot.  The 
chief  need  in  these  regions  is  for  agricultural  education, 
and  the  schools  are  now  being  urged  to  organize  farm 
training  wherever  possible.  At  Palermo,  where  agricul- 
tural courses  were  started  early,  extremely  worthwhile 
results  have  been  obtained  from  instructing  the  ignorant 
and  conservative  Sicilian  peasant  in  modern  agricultural 
methods.  Knowledge  of  this  kind  will  economically 
more  than  compensate  a  wounded  peasant  for  his  phys- 
ical handicap. 

In  some  districts  in  Italy  famous  old  handicrafts  still 
flourish  and  bring  high  pay  to  a  skilled  worker.  A 
cripple  can  very  well  work  at  such  a  craft  if  his  injuries 
are  not  of  the  arms  or  hands,  and  so  a  number  of  the 
schools  have  courses  in  these  skilled  trades.  Several 
teach  bookbinding,  which  in  Italy  is  still  regarded  as  an 
art;  others,  fine  cabinet-making  or  art  pottery,    Florence 


184 THE      DISABLED      SOLDIER 

has  its  famous  toys,  and  Venice  teaches  the  old  Venetian 
arts  of  wrought  iron  and  stamped  leather. 

All  the  schools  have  employment  committees  which 
are  assisted  in  their  work  by  a  central  placement  office. 
Many  of  the  men  of  course  go  back  to  their  own  village 
and  set  up  their  shop  in  their  house.  In  cases  where 
they  go  to  the  large  cities  employers  have  been  found 
generally  anxious  to  help:  the  Electro-Technical  Society, 
for  example,  has  made  a  list  of  the  positions  it  can  offer 
to  cripples  and  the  injuries  compatible  with  them. 
Private  firms  are  obliged  to  reinstate  their  employees 
crippled  in  the  war  if  the  employees  can  pass  the  required 
physical  tests.  Accident  insurance  companies  are  not 
allowed  to  increase  their  rates  to  employers  of  war 
cripples  unless  more  than  a  certain  proportion  of  the 
employees  are  disabled. 


KINGDOM      AND      DOMINION  185 

CHAPTER  XIV 

KINGDOM  AND  DOMINION 

When  England  sent  her  first  "contemptible  little  army" 
to  the  continent  in  defense  of  the  violated  rights  of 
Belgium,  it  was  followed  not  alone  by  more  Britishers 
but  by  troops  from  every  corner  of  the  globe.  In  every 
dominion  of  the  empire  troops  were  enlisted  to  "fight 
for  the  right"  as  the  home  country  had  seen  it,  and  were 
dispatched  to  the  front  as  fast  as  circumstances  allowed. 

Great  Britain  and  every  one  of  her  dominions,  in  con- 
sequence of  their  heroic  stand  for  the  benefit  of  civili- 
zation, have  had  to  face  the  problem  of  the  returning 
disabled  soldier.  In  the  solutions  attained  by  these 
commonwealths,  dealing  as  they  have  with  Anglo-Saxons, 
men  of  similar  traditions,  habits,  and  impulses  as  our- 
selves, the  United  States  must  find  peculiar  interest 
and  derive  unusual  profit  from  the  showing  of  their  ex- 
perience. 

When  the  first  British  disabled  began  to  return  to  the 
streets  of  London,  there  was  scant  provision  for  their 
care. 

Now  to  every  British  soldier  who  lies  in  the  hospital 
ward  three  possibilities  are  open — a  visit  from  the  dark- 
winged  Messenger,  a  period  of  convalescence  and  the 
buckling  on  again  of  the  sword  for  another  thrust  at  the 
Hun,  or  "Blighty,"  the  old  familiar  haunts,  an  economic 
crutch  in  the  shape  of  a  pension,  and  a  job  suited  to  his 
physical  limitations.  As  surely  as  the  stricken  deer 
seeks  the  familiar  glades  so  does  the  discharged  warrior 


186  THE      DISABLED      SOLDIER 

turn  his  halting  steps  to  the  sheep  downs  of  the  south 
or  the  smoky  towns  of  Lancashire,  the  heather  hills  of 
Scotland,  the  mines  of  Cardiff,  or  the  long,  long  way  to 
Tipperary. 

If  we  could  visualize  the  procession  of  maimed  and 
disabled  men  in  mufti  as  it  leaves  the  discharge  depot 
we  would  see  it  melt  away  into  the  economic  horizon  of 
every  portion  of  the  United  Kingdom,  to  carry  to  each 
county,  borough,  and  town  the  problem  of  the  care  of 
the  disabled  man  as  a  legacy  of  the  Great  War  for  the 
stability  of  those  free  institutions  the  Anglo-Saxon  prizes 
above  life  or  sound  limbs.  And  in  each  and  every  dis- 
trict he  will  find  that  provision  has  been  made  to  con- 
tinue his  medical  treatment,  choose  for  him  an  occupa- 
tion suited  to  the  abridgement  of  his  powers,  and  induct 
him  into  it  after  proper  training.  Should  he  be  in  doubt 
as  to  his  rights  under  the  new  and  unusual  laws  of  the 
realm,  the  Local  Pensions  Committee  stands  ready  to 
secure  his  rights,  succor  his  family,  and  educate  him  to 
surmount  the  handicap  the  enemies  of  civilization  have 
laid  upon  him.  And  this,  not  because  England  thought 
this  out  as  the  best  way  to  care  for  her  disabled  heroes, 
but  because  it  chimed  in  with  her  way  of  doing  things 
in  the  past.  Local  government  has  always  been  a  cher- 
ished prerogative  of  the  English  commonwealth  since 
the  days  of  the  petty  kingdoms.  A  representative  gov- 
ernment may  sketch  its  plans  in  the  large,  but  the  English 
community  must  be  given  a  free  hand  in  filling  in  the 
local  details.  So  when  the  Disabled  Sailors'  and  Soldiers' 
Committee  reported  to  Parliament  in  1915  that  "the 
care  of  the  sailors  and  soldiers,  who  have  been  disabled 
in  the  war,  is  an  obligation  which  should  fall  primarily 
upon  the  state"  and  that  body  passed  the  Naval  and 


KINGDOM      AND      DOMINION  187 

Military  War  Pensions  Act  in  1915  to  provide  for  "the 
care  of  officers  and  men  disabled  in  consequence  of  the 
present  war,"  the  plan  proposed  to  commit  the  disabled 
man  to  the  care  of  a  local  committee  of  his  own  towns- 
men. To  be  sure,  later  developments  of  the  plan  necessi- 
tated modifications  of  this  scheme  in  the  interests  of  co- 
ordinated measures  for  the  economic  welfare  of  the 
realm,  but  this  is  essentially  the  genius  of  the  English 
plan — local  responsibility  for  bringing  the  opportunities 
afforded  by  the  government  to  the  door  of  each  dis- 
abled man. 

Specific  instances  of  like  care  were  not  wanting.  The 
Incorporated  Soldiers'  and  Sailors'  Help  Society,  which 
was  established  under  royal  patronage  at  the  close  of 
the  South  African  War,  had  sought  to  aid  the  ex-service 
man  in  finding  employment  by  furnishing  him  with  the 
name  of  a  "friend"  in  each  parish  or  ward  throughout 
the  empire.  The  Old  Age  Pensions  scheme  of  the  state 
was  administered  by  local  committees  in  every  borough 
and  urban  district  having  a  population  of  20,000  or  over. 
The  necessities  of  the  families  of  the  enlisted  men  had 
long  been  looked  after  by  the  Soldiers'  and  Sailors' 
Families  Association  by  a  ramification  of  local  commit- 
tees composed  largely  of  clergymen  and  ladies  of  leisure 
in  all  parts  of  the  country. 

It  was  quite  natural,  therefore,  that  Parliament  should 
look  to  a  local  committee  to  take  the  hand  of  the  disabled 
man  and  lead  him  all  the  way  back  to  a  life  of  productive 
and  contented  activity.  It  was  thought  that  the  neces- 
sities of  each  man  could  best  be  assessed  and  provided 
for  by  a  committee  of  his  townsmen  familiar  with  the 
conditions  that  environed  him  and  his  family.  The 
soundness  of  this  principle  cannot  be  questioned,  and 


188 THE      DISABLED      SOLDIER 

while  it  may  not  make  for  uniformity  it  at  least  has  the 
advantage  of  intimacy.  It  is  the  recognition  of  a  prin- 
ciple, expressed  many  times  in  Parliamentary  debate 
and  charity  organization,  that  in  dealing  with  individ- 
uals in  widely  differing  stations  in  life  and  with  peculiar 
necessities,  a  human  element  must  somehow  be  provided 
which  the  uniformity  of  governmental  regulations  does 
not  permit.  The  human  element — a  quick  sympathy, 
an  intimate  knowledge  of  a  disabled  man's  circumstances, 
a  way  to  help  unfamiliar  to  rules  of  a  bureau — this  can 
be  supplied  best  by  the  local  committees. 

And  so  England  followed  the  blazed  trail  of  private 
philanthropic  organizations  and  established  Local  Pen- 
sions Committees  in  every  county,  county  borough,  and 
urban  district  having  a  population  of  not  less  than 
50,000.  The  committees  are  responsible  to  the  Ministry 
of  Pensions,  which  establishes  rules  and  regulations  to 
secure  uniformity  in  the  provisions  they  make  for  the 
men  committed  to  their  care.  The  appointment  of  these 
committees  is  largely  left  to  the  local  authorities,  but  in 
general  they  must  include  some  women,  some  represen- 
tatives of  labor,  and  members  of  the  Soldiers'  and  Sailors' 
Families  Association,  and  of  the  Soldiers'  and  Sailors' 
Help  Society.  A  salaried  secretary  appointed  by  the 
Ministry  of  Pensions  is  a  kind  of  liaison  officer  between 
the  local  body  and  the  central  office. 

The  duties  of  the  Local  Pensions  Committee  are 
broadly  sketched  in  the  instructions  of  the  Ministry  of 
Pensions:  "The  local  committee  should  regard  them- 
selves as  responsible  for  all  discharged  men  of  this  class 
(i.  e.,  disabled)  living  in  their  area.  They  should  make 
it  their  business  to  get  in  touch  with  every  such  man, 
whether  or  not  he  has  obtained  employment  or  occupa- 


KINGDOM      AND      DOMINION  189 

tion  since  his  discharge,  and  see  that  the  treatment  or 
training  which  his  condition  needs  is  secured  for  him 
when  he  needs  it.  .  .  .  It  is  vitally  important  both 
in  the  man's  interest  and  in  that  of  the  Nation  that  any 
case  which  needs  either  treatment  or  training  should  be 
taken  in  hand  at  once.  Local  committees  must  not  be 
content  with  dealing  only  with  the  men  who  happen  to 
present  themselves  to  them  for  assistance;  they  must 
see  that  they  have  information  as  to  the  condition  of 
all  discharged  pensioners  in  their  areas,  and  make  it  a 
point  of  getting  in  touch  with  them  directly  they  are 
discharged." 

The  committee  is  to  be  guided  in  its  decisions  in  regard 
to  suitable  training  for  a  man  by  several  considerations. 
His  previous  occupation  must  have  weight.  The  pro- 
posed occupation  must  be  suitable  to  his  age,  disable- 
ment, and  physical  condition.  If  any  recommendation 
as  to  his  training  has  been  indicated  on  his  notification 
of  award  for  pension  or  by  a  hospital  visitor,  this  must 
be  considered.  Not  least  of  the  factors  entering  into  a 
solution  of  the  problem  before  the  committee  must  be 
the  opportunities  for  a  living  wage  in  the  occupation 
chosen  for  him. 

It  must  be  quite  clear  that  if  the  local  committee  were 
left  to  its  own  devices  wholly  in  choosing  an  occupation 
for  the  man  the  result  in  the  field  of  industry  might  be 
disastrous.  The  influx  of  a  large  number  of  disabled 
men  into  a  particular  occupation  without  some  standard 
of  training  might  arouse  antagonisms  that  would  be  un- 
fortunate. This  necessitated  some  rulings  by  the  central 
office  in  the  interests  of  coordinated  effort.  Both  the 
employers  of  labor  and  the  work  people  must  have  some 
voice  in  the  matter,  especially  in  a  country  whose  labor 


190 THE   DISABLED   SOLDIER 

organization  has  made  such  strides.  The  necessary  ma- 
chinery was  provided  by  the  Ministry  of  Pensions  co- 
operating with  the  Ministry  of  Labor.  Trade  Advisory 
Committees  have  been  appointed  for  most  of  the  prin- 
cipal trades.  Each  committee  is  composed  of  an  equal 
number  of  employers  and  work  people.  It  is  the  duty 
of  each  committee  to  advise  the  Ministry  of  Pensions 
as  to  conditions  under  which  the  training  of  men  in  that 
trade  can  best  be  given,  the  best  methods  of  training, 
the  suitable  centers  for  it,  and  in  general  to  secure  uni- 
formity in  the  training.  The  numerous  reports  already 
issued  contain  a  valuable  fund  of  information  regarding 
the  trade  from  the  viewpoint  of  the  man  who  is  physi- 
cally handicapped.  The  analysis  of  an  industry  with 
the  man  with  abridged  powers  in  view  is  a  phase  of  in- 
dustrial efficiency  which  the  war  has  developed.  Never 
again  can  the  old  laissez  faire  policy  of  allowing  the 
handicapped  man  to  stumble  along  the  industrial  road 
undirected  and  unassisted  prevail.  Society  cannot  again 
close  its  eyes  to  this  waste  of  human  efficiency  and  the 
heartbreak  of  the  man  whose  work  powers  are  unappreci- 
ated because  of  some  physical  abridgement  he  has  suffered. 
The  question  of  wages  to  be  paid  to  a  disabled  man 
will  always  be  a  vexing  problem.  Where  a  disabled  man 
can  do  his  full  stint  of  the  work  and  compete  with  his 
normal  fellows,  he  should  plainly  receive  the  equal  wages 
whether  he  is  receiving  a  pension  or  not.  But  there  are 
grounds  for  debate  when  the  man  is  physically  unable 
to  perform  a  full  task  either  in  hours  or  output.  The 
inevitable  tendency  will  be  for  the  employer  to  depre- 
ciate the  man's  ability.  The  exploitation  of  the  disabled 
man,  especially  when  he  is  receiving  a  pension,  is  feared 
by  organized  labor,  jealous  of  its  wage  standards.    An 


KINGDOM      AND      DOMINION  191 

eflfort  has  been  made  to  provide  machinery  for  obviating 
this  difficulty.  The  Ministry  of  Labor  has  set  up  in  the 
principal  industrial  centers  advisory  wages  boards  com- 
posed of  representatives  of  employers  and  work  people 
and  three  members  of  the  Local  Pensions  Committee. 
This  committee  is  to  advise  the  local  committee,  or  an 
employer  desirous  of  employing  a  handicapped  man, 
what  would  be  an  equitable  wage  in  his  particular  case, 
taking  into  consideration  the  man's  physical  capacity 
and  the  current  rate  of  wages  for  the  industry  in  that 
locality.  The  question  of  a  man's  pension  is  not  to  be 
taken  into  account.  The  committee  acts  purely  in  an 
advisory  capacity,  but  it  is  hoped  by  these  means  to 
provide  against  the  exploitation  of  cripples  or  the  lower- 
ing of  trade  standards. 

It  is  the  duty  of  the  Local  Pensions  Committee  to 
provide  facilities  for  the  training  of  its  disabled  ex-service 
men.  It  was  soon  seen  that  the  training  facilities  of  a 
larger  area  than  that  within  the  jurisdiction  of  most 
local  committees  must  be  made  available  if  the  variety 
of  occupations  demanded  were  to  be  provided.  So  Joint 
Advisory  Committees,  composed  of  the  representatives 
of  local  committees,  were  formed  in  1916  to  arrange  com- 
prehensive schemes  for  utilizing  the  facilities  for  tech- 
nical education  within  whole  counties  or  groups  of 
counties.  Twenty-two  of  these  joint  committees  were 
formed  in  the  United  Kingdom.  They  surveyed  the 
technical  facilities  in  their  respective  districts  and  syn- 
dicated them  in  the  interests  of  all. 

For  many  years  the  British  government  has  aided 
local  technical  schools,  and  the  result  has  been  a  surpris- 
ingly large  number  of  institutions  where  one  or  more 
trades  are  taught.     These  trades  cover  the  principal 


192  THE      DISABLED      SOLDIER 

industries  of  the  country.  The  number  of  technical 
schools  in  the  industrial  counties  of  Lancashire  and 
Yorkshire  is  particularly  noticeable.  Both  of  these 
counties  formulated  ambitious  schemes  for  the  training 
of  disabled  men  in  every  variety  of  industry  pertaining 
to  the  soil,  the  mine,  the  factory,  and  the  sea.  The  co- 
operation of  all  the  principal  technical  schools  in  the 
training  of  disabled  men  was  secured.  The  offer  of  facili- 
ties seems  to  have  greatly  exceeded  the  demand. 

Not  only  have  the  technical  schools  been  utilized  for 
re-education  but  many  men  have  been  trained  directly 
in  workshops  and  factories.  The  plan  advocated  by 
several  of  the  trades  advisory  committees  provides  that 
a  man  shall  spend  part  of  his  time  at  a  school  and  part 
of  his  time  in  actual  work  in  a  factory  or  workshop.  By 
this  means  a  balance  is  maintained  between  the  theo- 
retical and  the  practical. 

It  must  not  be  supposed  that  every  man  returns  to 
his  home  district  absolutely  unprepared  for  an  altered 
industrial  career.  Many  of  the  men  avail  themselves  of 
the  opportunities  afforded  by  the  workshops  connected 
with  the  hospitals  in  which  they  have  spent  their  period 
of  convalescence.  Early  in  the  history  of  the  war  cura- 
tive workshops  were  established  in  the  hospitals  of  Roe- 
hampton  and  Brighton,  whither  men  who  have  suffered 
some  amputation  are  sent.  Major  Mitchell,  the  director 
of  one  of  the  leading  technical  institutes,  was  chosen  to 
direct  the  courses.  The  therapeutic  value  of  manual 
work  has  been  fully  recognized,  and  many  a  man,  invited 
to  busy  himself  in  a  workshop  with  the  tools  of  a  man's 
job  ready  to  his  hands,  has  not  only  found  a  stimulus 
to  the  functional  activity  of  injured  members  but  has 
actually  learned  a  trade  while  waiting  for  nature  to 


KINGDOM      AND      DOMINION  193 

heal  his  wounds  and  the  government  to  furnish  him 
with  an  artificial  limb.  Not  every  man  avails  himself 
of  the  opportunities  offered  him  in  the  hospital  and 
must  look  to  his  local  committee  to  furnish  the  oppor- 
tunities for  training  he  slighted  or  to  supplement  his 
training  by  continuation  courses. 

Upon  his  discharge  from  military  service  the  disabled 
man  is  granted  a  pension  based  upon  the  degree  of 
physical  disability  he  has  suffered  and  is  free  to  return 
to  his  home  locality.  His  future  lies  within  the  advisory 
jurisdiction  of  his  Local  Pensions  Committee  acting  for 
the  Ministry  of  Pensions.  He  may  choose  to  live  a  life 
of  inactivity  depending  for  a  scanty  subsistence  upon 
the  slender  stipend  granted  him  by  the  Ministry  of 
Pensions.  He  may  accept  a  job  ready  to  his  hand, 
because  of  acute  industrial  conditions  caused  by  the  war, 
from  which  he  is  likely  to  be  ousted  by  the  return  of  able- 
bodied  men  upon  the  demobilization  of  the  army.  Or, 
he  may  accept  training  at  the  expense  of  the  state  and 
become  a  skilled  worker  with  better  prospects  of  con- 
tinued employment  when  normal  times  return.  The 
good  sense  of  the  man  and  the  persuasiveness  of  the 
local  committee  will  largely  determine  what  course  he 
is  to  pursue. 

If  he  elects  to  take  training  he  will  receive,  during  the 
time  required  for  his  re-education  up  to  six  months,  his 
total  disability  pension  together  with  a  family  allowance, 
all  necessary  fees  will  be  paid  for  him  and  at  the  end  of 
his  course  he  will  receive  a  bonus  for  each  week  of 
training.  The  state  cares  for  both  himself  and  his 
family  during  his  period  of  re-education.  At  the  end  of 
his  course  he  will  be  fortified  against  the  exigencies  of 
the  future  by  the  wages  he  can  earn  at  a  skilled  trade 


194  THE      DISABLED      SOLDIER 

and  the  regular  pension  to  which  his  injuries  entitle  him. 
It  is  expressly  stipulated  that  his  pension  shall  never 
suffer  diminution  because  of  his  increased  earning 
capacity.  Many  disabled  men  are  now  receiving  from 
this  dual  source  larger  incomes  than  they  enjoyed  before 
they  entered  the  service  of  their  country. 

The  demand  for  disabled  men  who  have  received 
training  has  been  so  great  that  no  difficulty  has  been 
found  in  finding  employment  for  them.  The  admirable 
system  of  state  labor  exchanges  provides  the  facilities 
for  placing  disabled  men  in  industry  and  their  services 
will  be  in  still  greater  demand  when  peace  returns  and 
conditions  of  employment  are  greatly  altered  by  the 
return  of  men  from  the  front. 

While  the  preparation  of  disabled  men  to  enter  into 
competition  with  their  normal  fellows  seems  to  promise 
the  best  results  on  the  whole,  still  it  must  be  recognized 
that  many  men  with  severe  physical  limitations  must  be 
provided  for  in  special  institutions  under  favorable  work 
conditions.  Specialized  machinery  and  carefully  planned 
team  work  can  make  productive  units  of  badly  handi- 
capped men  with  whom  the  average  employer  is  not 
willing  to  bother.  Large  provision  for  this  class  of  men 
has  been  made  by  the  Lord  Roberts*  Workshops,  which 
are  being  multiplied  in  different  parts  of  the  country. 
Some  ten  years  before  the  war  the  Soldiers'  and  Sailors' 
Help  Society  opened  workshops  in  London  to  provide 
employment  for  disabled  ex-service  men  for  whom  it 
was  extremely  difficult  to  find  work.  The  work  has  been 
greatly  expanded  since  the  war,  and  the  enterprise  has 
taken  the  name  of  the  nation's  military  idol,  who  was 
greatly  interested  in  the  project.  Toy-making,  with  the 
many  processes  involved,  has  been  found  a  suitable  in- 


SHU  in  the  National  Service.     Making  submarine  fittings 
and  thus  coniinuing  to  help  defeat  the  enemy 


A  Wage-Earner  Once  More.    The  loss  of  a  right  arm  does  not  prevent 
this  British  soldier  from  doing  useful  work  in  a  laboratory 


KINGDOM      AND      DOMINION  195 

dustry  for  many  types  of  disability,  and  the  enterprise 
has  been  successfully  conducted  on  a  sound  commercial 
basis.  The  plans  of  the  society  contemplate  facilities  in 
the  eleven  workshops  in  different  parts  of  the  country 
for  the  accommodation  of  between  four  and  five  thou- 
sand men. 

Great  Britain's  colonies  have,  one  by  one,  followed 
the  trail  blazed  by  the  pioneers  of  re-education  and  are 
now  admirably  equipped  to  offer  training  and  employ- 
ment to  the  disabled  soldiers  of  their  own  forces.  Canada, 
Australia,  New  Zealand,  South  Africa,  and  India  all  are 
now  prepared  to  receive  from  the  battlefields  those  whom 
•they  sent  forth,  to  fit  again  for  civilian  pursuits  those 
whom  war  has  maimed. 

Great  credit  is  due  our  neighbor  on  the  north  for  her 
promptness  in  making  provision  for  her  disabled  men. 
When  the  ambulance  transports  landed  the  first  few 
bands  of  disabled  Canadians  at  the  clearing  depots  in 
Halifax,  St.  John,  or  Quebec,  there  were  medical  boards 
to  examine  them,  and  hospitals  on  wheels  to  carry  them 
comfortably  to  their  military  districts.  After  a  short 
stay  at  home  the  soldiers  are  expected  to  report  back  to 
the  military  convalescent  hospitals  named  in  their  passes. 
Then  their  physical  rehabilitation  begins. 

In  the  hands  of  the  Invalided  Soldiers'  Commission, 
an  outgrowth  of  the  Military  Hospitals'  Commission,  are 
the  duties  of  re-educational  work  and  vocational  training 
in  Canada,  whether  provided  for  men  undergoing  treat- 
ment in  military  hospitals  or  after  discharge. 

Those  Canadians  who  have  given  an  arm  or  a  leg  in 
service  are  fitted  with  artificial  limbs  in  Toronto,  where 
a  government  limb  factory  has  been  established.  The 
fitting  of  limbs  is  done  in  a  branch  of  the  Military  Ortho- 


196  THE      DISABLED      SOLDIER 

pedic  Hospital  at  North  Toronto,  and  local  branches  for 
fitting  have  recently  been  established  at  several  points. 
The  leg  made  in  Canada  is  of  the  standard  American 
type.  For  men  who  have  been  discharged  from  the  hos- 
pitals, artificial  limbs  are  provided  free,  and  arrange- 
ments have  been  made  by  which  the  government  will 
keep  them  in  repair. 

To  those  of  her  men  who  are  prevented  by  their  dis- 
abilities from  resuming  their  former  occupations,  Canada 
ofifers  special  training  in  a  new  trade  at  the  expense  of 
the  Invalided  Soldiers'  Commission.  While  the  soldier 
is  still  in  the  hospital,  his  future  is  discussed  with  him 
by  a  vocational  officer,  and  a  plan  of  action  is  decided 
upon.  The  man  comes  up  before  the  Disabled  Soldiers' 
Training  Board,  which  consists  of  the  district  vocational 
officer,  a  special  medical  officer,  and  a  representative  of 
the  local  employment  organization  dealing  with  the 
problem  of  placing  returned  men  in  industry.  This 
board  determines  the  man's  eligibility  for  training  under 
the  regulations  and  the  occupation  for  which  the  man 
is  to  be  trained.  The  place  of  training,  length  of  course, 
method,  and  cost  are  determined  by  professional  mem- 
bers of  the  staff  of  the  Invalided  Soldiers'  Commission. 
The  plan  is  then  recommended  to  the  authorities  of  the 
commission  at  Ottawa.  Should  there  be  no  objection, 
the  man's  re-education  is  begun. 

The  disabled  soldier  is  given  an  opportunity  to  change 
his  course  of  training,  if  it  is  found  that  the  original 
choice  was  unhappy.  The  man  approved  for  re-educa- 
tional training  is  given  a  pension  and  a  vocational  allow- 
ance, also  an  allowance  for  his  dependents,  so  that  he  is 
relieved  of  financial  worry  while  he  is  undergoing  in- 
struction. 


KINGDOM      AND      DOMINION  197 

At  a  typical  Canadian  school  of  re-education,  the  men 
attend  as  day  pupils,  receiving  instruction  in  machine- 
shop  practice,  gas-engine  operation,  automobile  me- 
chanics, electric  power  station  practice,  railroad  or  com- 
mercial telegraphy,  surveying,  architectural  drafting',  the 
manufacture  and  repair  of  artificial  limbs,  shoe-repairing, 
moving  picture  operating,  steam  engineering,  heating 
plant  operation,  electrical  work,  civil  service,  commercial 
courses — bookkeeping,  accountancy,  stenography,  type- 
writing, secretarial  work  for  municipalities — cabinet-* 
making,  sanitary  inspection,  meat  and  food  inspection, 
to  be  instructors  in  vocational  subjects,  wood-working, 
and  machine  operation.  On  a  prairie,  several  miles  out 
from  the  school,  men  are  taught  to  operate  gas  tractors, 
with  which  they  plow  up  virgin  soil,  and  do  a  hard  day's 
work  as  they  would  under  actual  employment.  There 
are  also  classes  in  mathematics,  English,  and  civics. 

The  best  schools  and  courses  will  not  benefit  the  dis- 
abled trainee  unless  he  has  the  right  teachers  and  unless 
there  is  a  real  bond  of  friendship  between  the  individual 
man  and  the  vocational  officer.  The  teachers  sought 
are  skilled  men  with  wide  experience,  rather  than  peda- 
gogues. Those  most  desired  are  competent  men  who 
have  seen  military  service  overseas,  physically  handi- 
capped civilians,  or  civilians  not  eligible  for  military 
service.  Instructors  are  not  in  uniform,  but  serve  as 
civilians. 

Some  men  are  placed  for  training  in  factories,  under  a 
modified  apprenticeship  system.  Their  instruction  is 
carefully  supervised  by  a  visiting  inspector,  and  the 
progress  made  is  recorded  and  checked  up.  This  method 
of  instruction  is  meeting  with  more  and  more  favor  in 
Canada,  and  the  results  have  been  exceedingly  inter- 


198 THE      DISABLED      SOLDIER 

esting.  The  men  thus  placed  receive  no  wages — unless 
the  employer  voluntarily  pays  them  as  the  training 
progresses — but  receive  from  the  government  the  same 
benefits  as  to  pension  and  training  allowance  as  the  men 
re-educated  in  schools. 

By  arrangement  with  the  various  provinces,  it  was 
agreed  that  the  Commission  reserved  the  right  to  place 
in  employment  graduates  of  the  re-educational  system, 
while  men  able  on  return,  to  Canada  to  re-enter  civil  life 
without  training  were  to  be  placed  by  provincial  com- 
missions. There  has  been  put  into  force  since  the  begin- 
ning of  1918  a  system  of  placement  and  follow-up  for 
men  completing  courses  under  the  Invalided  Soldiers' 
Commission.  Complete  records  show  where  men  are 
employed  and  the  wages  they  are  earning.  Some  of  the 
figures,  for  example,  comparing  wages  before  enlistment 
and  after  re-education  show  that  the  increase  in  earning 
power  of  the  first  hundred  men  graduating  in  Montreal 
— pension  payments  not  being  taken  into  account — aver- 
aged fourteen  per  cent. 

Australia  calls  her  work  of  refitting  disabled  soldiers 
for  civil  pursuits  "repatriation."  At  first,  as  in  England, 
private  agencies  assumed  the  burden  of  caring  for  re- 
turned fighters.  Later,  when  Australians  began  to  come 
back  from  the  battlefields  in  increasing  numbers,  the 
government  recognized  its  duty  to  them  by  passing  in 
September,  1917,  the  Australian  Soldiers'  Repatriation 
Act.  This  act  placed  the  control  of  repatriation  in  the 
hands  of  a  commission  consisting  of  seven  members.  In 
the  capital  city  of  each  state  local  boards  were  created  to 
act  as  agents  in  carrying  out  the  plans  of  the  commission. 

The  mere  passage  of  the  measure  did  not  assure  the 
carrying  out  of  the  scheme  for  restoring  disabled  men  to 


KINGDOM      AND      DOMINION  199 

self-support.  At  first,  a  soldier  was  registered  at  the 
repatriation  office  only  when  he  applied  there  for  help. 
Under  the  act,  the  first  task  of  the  repatriation  com- 
mission, according  to  Senator  Millen,  would  be  to  register 
the  condition  and  requirements  of  all  returning  soldiers, 
either  on  the  transports  or  before  they  left  England. 
This  early  registration  would  give  the  commission  some 
idea  of  the  number  of  men  they  had  to  deal  with,  their 
needs,  wishes,  and  qualifications. 

For  those  whose  disabilities  prevent  them  from  secur- 
ing employment  without  re-educational  training,  the  gov- 
ernment plans  to  provide  preliminary  training  in  curative 
workshops  attached  to  the  hospitals,  and  then  more 
advanced  training.  Such  work  has  been  launched  in  the 
hospitals  at  Sydney  and  Melbourne. 

To  meet  the  needs  of  the  first  amputation  cases, 
Australia  was  forced  to  import  artificial  limbs  from 
England,  an  unsatisfactory  procedure  at  best.  Later,  the 
Surgeon  General  of  the  Defense  Department  established 
limb  factories  in  Melbourne  and  Sydney.  To  start  the 
first  factory  in  Melbourne,  an  American  expert  was 
called  in. 

Under  the  act,  a  number  of  Local  Committees  were 
created  to  act  as  local  agents  for  the  Department  of 
Repatriation  in  regard  to  placing  of  men  in  employment. 
Various  labor  branches  were  formed  to  carry  on  the 
routine  work  of  the  ordinary  private  labor  agency,  and 
to  inform  the  department  as  to  returned  soldiers  in  their 
districts  wanting  work  and  as  to  vacancies  requiring 
men  to  fill  them.  Great  effort  is  being  made  by  the 
Repatriation  Department  to  list  employers  who  prom- 
ised to  re-employ  returned  soldiers  and  to  canvass  the 
field  for  employers  who  are  willing  to  take  on  disabled  men. 


200  THE      DISABLED      SOLDIER 

The  regulations  under  the  Repatriation  Act,  eflfective 
April  8,  1918,  authorize  the  creation  in  each  state  of  a 
Soldiers'  State  Industrial  Committee,  for  the  purpose  of 
facilitating  the  training  of  men  in  private  industrial 
establishments.  The  former  committee  has  power  to 
decide  disputes  arising  from  decisions  made  by  the  latter. 

A  Soldiers'  District  Industrial  Committee,  consisting 
of  a  chairman  appointed  by  the  Minister,  two  represen- 
tatives of  the  employers  in  the  trade  of  the  trainee,  and 
two  representatives  of  the  union  covering  the  trade  or 
calling  of  the  trainee,  have  these  powers:  (1)  to  consider 
opportunities  for  employment  of  soldiers  or  their  depen- 
dents; (2)  to  decide  after  trial  as  to  the  suitability  of 
applicants  for  particular  callings;  (3)  to  assess  the  effi- 
ciency of  the  trainee  after  the  commencement  of  his 
training;  (4)  to  re-assess  the  trainee's  efficiency  every 
three  months;  (5)  periodically  to  review  the  facilities 
for  training  in  workshops  and  technical  schools;  (6)  to 
deal  with  disputes  between  persons  entered  for  training 
in  private  workshops  and  the  employer,  in  particular 
disputes  arising  as  to  what  is  the  ruling  rate  of  wages  in 
any  industry;  and  (7)  to  have  power  when  necessary 
to  call  for  and  take  evidence. 

In  his  speech  before  the  Senate  on  May  2,  1918,  the 
Honorable  E.  D.  Millen,  Minister  for  Repatriation, 
pointed  out  that  since  it  was  not  possible  to  find  employ- 
ment for  all  disabled  men  in  the  ordinary  channels  of 
industry,  it  would  be  necessary  to  find  "reserve  employ- 
ment." An  arrangement  was  made  with  state  govern- 
ments by  the  federal  authorities  to  grant  the  states  as  a 
gift  an  amount  of  money  to  make  up  the  deficiency 
caused  by  the  employment  of  such  men  as  could  not 
give  the  full  day's  work  in  return  for  the  full  day's  wage 


KINGDOM      AND      DOMINION  201 

of  an  able-bodied  worker.  For  instance,  if  the  full  wage 
paid  be  IO5.  per  day,  and  the  returned  soldier  em- 
ployed can  earn  no  more  than  8s.  in  the  day,  owing  to 
some  little  incapacity,  the  difference  of  2s.  will  represent 
the  measure  of  his  inefficiency,  and  the  Repatriation 
Department  will  make  that  good  by  a  gift  of  the  amount 
to  the  state  governments  concerned.  Several  state 
governments  have  made  arrangements  to  employ  men 
on  such  terms  in  afforestation. 

Those  of  New  Zealand's  men  who  have  gone  to  the 
front  are  assured  of  the  best  possible  provision  for  their 
successful  re-entry  into  civilian  life  upon  their  return. 
The  whole  problem  of  the  returned  New  Zealander  is  in 
the  hands  of  the  Discharged  Soldiers'  Information  De- 
partment, which  has  established  a  network  of  local  com- 
mittees that  assume  the  responsibility  of  finding  suitable 
employment  for  the  men  in  his  own  community. 

Especial  effort  has  been  made  to  get  in  touch  with 
every  returning  soldier  to  ascertain  his  situation  and 
his  needs.  Representatives  of  the  Department  board  the 
incoming  transports,  or  arrange  to  secure  from  the  mili- 
tary authorities  on  board  ship  the  necessary  data  con- 
cerning each  man.  This  information  is  recorded  on  a 
card  in  the  central  register  of  the  Returned  Soldiers*  In- 
formation Department,  and  word  is  sent  informally 
regarding  the  home-coming  man  to  the  community  to 
which  he  is  to  return. 

The  duty  of  interviewing  the  discharged  soldier  is 
often  delegated  to  local  police  officials,  who  are  cau- 
tioned to  make  their  inquiries  sympathetically  and  tact- 
fully. The  interviewer  takes  with  him  a  blank  report 
to  fill  out  and  also  a  circular  of  information  for  the  soldier. 

If  a  man  does  not  require  the  department's  assistance. 


202  THE      DISABLED      SOLDIER 

the  interviewer  obtains  his  signature  to  that  effect. 
Many  of  the  men  do  not  require  assistance,  as  they  may 
have  business  or  farms  to  return  to,  or  may  have  suffi- 
cient private  means.  Others  may  have  obtained  em- 
ployment or  promises  of  employment. 

The  man  who  desires  employment  is  instructed  to 
get  in  touch  with  the  local  committee  in  his  home 
district. 

For  disabled  men  who  cannot  return  to  their  former 
occupations  free  tuition  has  been  offered  in  various  fields. 
On  the  state  farms,  men  are  taught  various  branches  of 
agriculture.  At  Lincoln  College,  Wellington,  where  free 
scholarships  are  offered  in  scientific  agricultural  training, 
those  who  desire  clerical  training  are  instructed  by  the 
New  Zealand  Society  of  Accountants.  In  addition  to 
classroom  teaching,  correspondence  courses  are  main- 
tained for  those  who  cannot  attend  in  person. 

At  Wellington  Technical  College  instruction  is  pro- 
vided for  disabled  men  in  building  construction,  decora- 
tion, painting,  carpentry  and  joinery,  plumbing,  machine 
work,  jewelry  making,  metal  work,  plastering  and  model- 
ing.    Other  centers  provide  different  courses  of  training. 

To  remove  any  financial  difficulties  for  men  desiring 
to  take  training,  the  government  decided  to  grant  to 
ex-soldiers  attending  classes  a  maintenance  allowance  of 
not  more  than  one  pound  a  week,  irrespective  of  pension 
payment.  This  allowance  is  conditioned  upon  the  man's 
good  conduct,  regular  attendance,  satisfactory  progress, 
and  suitability  for  the  chosen  trade. 

Despite  New  Zealand's  persevering  efforts  to  provide 
suitable  training  for  her  disabled  men,  the  results  have 
not  been  encouraging,  for  comparatively  few  men  have 
availed  themselves  of  the  opportunities  offered.     The 


KINGDOM      AND      DOMINION  203 

results  in  obtaining  employment  for  disabled  men, 
however,  have  been  exceptionally  successful.  This  may 
be  due  in  some  part  to  the  abnormal  demand  for  labor 
in  New  Zealand  at  the  present  time  and  to  the  desire 
on  the  part  of  most  of  the  returned  soldiers  to  get  back 
as  quickly  as  possible  to  remunerative  and  productive 
employment. 

A  school  of  re-education  in  India  is  indeed  a  new  thing 
under  the  sun.  To  teach  disabled  soldiers  of  the  Indian 
forces  such  trades  as  motor  mechanics  and  tailoring  in 
order  to  make  them  self-supporting  must  appear  won- 
derful to  us  who  have  been  accustomed  to  regard  the 
hordes  of  mendicants  in  India  as  a  natural  element  in 
that  country's  curious  make-up. 

At  Bombay  is  one  of  the  most  picturesque  schools  in 
the  world.  Queen  Mary's  Technical  School  for  Disabled 
Indian  Soldiers  it  is  called,  founded  over  a  year  ago  by 
Lady  Willingdon,  wife  of  the  Governor  of  Bombay. 
Here  there  are  hundreds  of  India's  returned  fighters, 
men  from  all  ranks  and  castes,  working  zealously  under 
competent  instructors  who  teach  them  trades  that  range 
from  poultry  raising  and  farming  to  tailoring,  motor 
mechanics,  engineering,  carpentering,  motion  picture 
operating,  and  oil  engine  driving.  For  six  months  or 
more  these  olive-skinned,  curly  bearded  trainees  work  in 
the  shops  until  they  are  "graduated"  and  sent  out  to 
trades  at  which  they  can  earn  from  twenty  to  one  hun- 
dred rupees  a  month,  or  about  six  to  thirty-two  dollars. 
Not  a  great  income,  perhaps,  but  sufficient  in  view  of 
the  fact  that  the  average  man  in  India  can  live  com- 
fortably on  about  six  dollars  a  month. 

The  building  itself  is  at  Byculla.  It  is  splendidly 
appointed  with  sitting-rooms,  dormitories,   and  work- 


204 THE      DISABLED      SOLDIER 

shops,  and  is  surrounded  by  beautiful  grounds  where  the 
pupils  take  their  exercise  or  spend  pleasant  hours 
conversing  or  reading.  Spacious  verandas  afford  them 
ample  space  for  games  and  amusements.  In  the  well- 
ventilated  dormitories  each  man  has  beside  his  bed  his 
own  lockup  in  which  he  keeps  his  personal  belongings. 

Queen  Mary's  School  affords  the  men  every  oppor- 
tunity to  take  their  training  in  comfort  and  without 
financial  worry.  Clothes,  bedding,  and  food  are  supplied. 
To  those  who  have  to  come  from  a  distance  return  railway 
tickets  and  traveling  expenses  are  given.  When  a  man 
finishes  his  course,  he  is  supplied  free  with  a  set  of  tools 
for  his  trade. 

Trained  men  are  placed  in  Bombay  and  other  indus- 
trial centers  in  workshops  and  factories;  with  regiments 
or  the  army  clothing  department  as  tailors;  in  the 
mechanical  transport  service  as  chauffeurs;  in  the  gov- 
ernment dockyards,  ordnance  factories,  and  arsenals  as 
turners,  fitters,  machinemen,  engine  drivers,  and  am- 
munition box  makers. 

Artificial  limbs  are  furnished  to  cripples  at  one  of  the 
hospitals  in  Bombay,  while  in  hospitals  at  Dehra,  Dun, 
and  Mussoorie  reconstructive  medical  treatment  is  pro- 
vided for  the  benefit  of  disabled  men. 

In  addition  to  the  employment  department  of  the 
Queen  Mary's  Technical  School  there  have  been  formed 
at  the  various  centers  in  India  bureaus  that  take  care  of 
the  problem  of  placing  disabled  men  in  suitable  employ- 
ment. 

In  Richmond  Park,  Surrey,  England,  on  a  magnificent 
twelve  acre  site,  stands  the  South  African  Military 
Hospital,  especially  built  for  permanently  disabled  South 
African  soldiers.    The  South  Africa  Union,  without  facili- 


KINGDOM      AND      DOMINION  205 

ties  for  carrying  on  the  necessary  work  of  re-education, 
found  it  advisable  to  establish  on  British  soil  a  hospital 
and  training  center  for  the  disabled  men  of  her  own  forces. 

Nothing  is  left  undone  to  make  the  disabled  soldier 
feel  at  home  in  his  new  quarters  in  Richmond  Park. 
Corridors  and  patients'  departments  of  the  hospital  are 
designated  after  familiar  places  and  streets  in  South 
Africa.  Thus,  the  main  entrance  opens  into  "Adderley 
Street,"  leading  into  "Market  Square"  in  Cape  Town, 
while  the  corridors  are  named  "Commissioner  Street," 
"Maitland  Street,"  and  "Sunnyside."  The  hospital 
buildings  were  designed  to  resemble  South  African 
colonial  timber-framed  dwellings  of  a  type  familiar  to 
the  disabled  man.  The  day  rooms  are  named  after  well- 
known  clubs,  "The  Ramblers,"  "The  Wanderers,  "and 
"The  Dustpan."  The  majority  of  the  beds  have  been 
endowed  with  money  collected  by  school  children  in 
South  Africa. 

One  of  the  hospital  buildings  is  a  large  concert  hall, 
used  at  times  for  church  services,  for  entertainments  for 
the  patients,  and  for  classes  in  typewriting,  bookkeeping, 
shorthand,  and  motion  picture  operating.  Adjacent  to 
the  concert  hall  and  established  in  connection  with  the 
hospital,  are  the  practical  workshops  or  vocational  train- 
ing classes.  Here  disabled  soldiers  are  taught  to  become 
metal  turners  and  fitters,  tool  makers,  brass  finishers, 
coppersmiths,  tinsmiths,  engine  drivers  and  attendants, 
acetylene  welders,  electrical  fitters  for  power,  light,  tele- 
phones, and  bells,  cinematograph  operators,  electrical 
testers,  meter  readers,  dynamo  and  switchboard  attend- 
ants, sub-station  and  accumulator  attendants,  motor  car 
drivers  and  repairers,  carpenters  and  joiners,  cabinet- 
makers, bootmakers  and  boot  repairers,  clerks,  store- 


206  THE      DISABLED      SOLDIER 

keepers  and  timekeepers,  bookkeepers,  accountants, 
salesmen,  secretaries,  and  managers.  The  vocational 
training  staff  consists  of  nine  experienced  instructors 
under  an  educational  organizer.  The  workshops  are 
registered  by  the  city  guilds  and  the  classes  are  inspected 
periodically  by  experts. 

When  a  man  enters  the  hospital  he  is  classified  under 
one  of  three  headings:  (1)  likely  to  become  fit  for  further 
military  service ;  (2)  doubtful  if  he  can  be  fitted  for  fur- 
ther military  service ;  or  (3)  unlikely  to  be  fit  for  further 
military  service.  If  he  falls  under  one  of  the  first  two 
classes,  he  is  given  curative  treatment  only,  to  return 
him  to  active  service  as  soon  as  possible.  If  he  comes 
under  the  third  heading,  his  case  is  investigated  to  deter- 
mine whether  he  will  require  vocational  training.  If  it 
is  found  that  the  does,  he  training  is  begun  as  early  as 
possible. 

The  hospital  and  vocational  staffs  cooperate  as  closely 
as  possible,  for  it  has  been  found  that  the  interest  of  the 
disabled  soldier  can  be  stimulated  in  some  type  of  work 
long  before  he  is  well  enough  to  leave  his  bed. 

According  to  Lieutenant-Colonel  Thornton:  "Under 
the  South  African  scheme  the  men  start  earlier  than  in 
any  other  institution  in  the  United  Kingdom,  as  this 
hospital  is  the  only  primary  hospital  which  has  Voca- 
tional Training  Classes  established  in  connection  with  it." 
This  statement  strikes  the  keynote  of  the  South  African 
plan.  The  fact  that  work  is  going  on  about  him  tends 
to  hearten  the  disabled  man ;  he  is  led  to  believe  that  he, 
too,  can  learn  a  trade.  His  training  is  begun  gradually, 
under  strict  medical  supervision.  As  soon  as  he  is  able 
to  sit  up  in  bed  he  is  given  typewriting  or  some  light 


KINGDOM      AND      DOMINION  207 

recreational  work  to  do.  This  fosters  the  desire  to  con- 
tinue a  course  of  training. 

The  injured  man  is  not  compelled  to  take  the  training. 
He  is  advised  by  the  doctor  and  by  the  vocational  staff 
to  attend  the  classes,  but  there  is  no  penalty  if  he  refuses. 
The  choice  of  a  career  is  settled  upon  at  a  conference  of 
a  doctor,  the  educational  organizer,  and  the  patient 
himself.  The  disabled  man's  own  inclination,  his  physical 
disability  and  his  suitability  for  the  calling  from  medical 
and  educational  standpoints,  are  the  determining  factors 
in  deciding  his  career. 

It  is  the  rule  at  the  South  African  Military  Hospital 
that  no  man  is  kept  a  day  longer  than  is  necessary  for 
his  medical  treatment.  After  his  discharge  he  is  kept  as 
an  out-student,  and  can  receive  further  medical  treat- 
ment as  an  out-patient. 

Upon  discharge  from  the  hospital,  the  men  are  not 
discharged  from  the  army,  but  are  kept  as  Union  soldiers 
in  hostels  close  to  the  hospital,  and  continue  their  training 
in  the  hospital  workshops.  The  men  are  uniformed  and 
subject  to  military  discipline.  A  man  may  or  may  not 
undergo  training  as  an  out-student  just  as  he  chooses, 
but  if  he  does  take  the  training  he  must  obey  military 
orders. 

•  Most  of  the  students  acquire  sufficient  training  at 
Richmond  Park  to  ensure  them  good  livelihoods  in 
South  Africa,  but  wherever  possible  they  are  placed  in 
workshops  in  England  for  several  weeks  prior  to  their 
embarkation  so  that  they  may  get  practical  experience 
under  actual  working  conditions.  During  their  stay  at 
Richmond  Park  the  men  receive,  instead  of  pay  or 
pension,  certain  allowances  from  Union  funds.  It  has 
been  estimated  that  over  ninety  per  cent,  of  those  for 


208  THE      DISABLED      SOLDIER 

whom  re-education  would  be  appropriate  undertake  the 
training. 

The  problem  of  reinstating  the  returned  man  in  civil 
life  in  South  Africa  has  been  placed  by  the  Union  govern- 
ment in  the  hands  of  the  Central  Committee  of  the 
Governor  General's  Fund,  and  the  whole  Union  has  been 
divided  into  districts  with  a  local  committee  in  charge 
of  each  area.  On  these  committees  rest  the  responsibility 
for  finding  employment  for  returned  soldiers. 

When  a  man  is  committed  to  the  workshops,  a  full 
report  is  prepared  as  to  his  previous  employment, 
physical  disability,  and  the  trade  for  which  he  is  to  be 
re-educated.  This  is  sent  to  the  Union  government  with 
copies  for  the  committee  for  the  area  in  which  the  man 
desires  to  live  upon  return  to  South  Africa.  Copies  of 
progress  reports  on  each  case  are  sent  from  time  to  time 
to  these  committees,  so  that  they  have  complete  infor- 
mation well  in  advance  and  should  thus  have  little  diffi- 
culty on  his  return  in  finding  for  him  suitable  work. 
In  fact,  students  are  often  notified  prior  to  their  return 
that  there  has  been  found  for  them  employment  upon 
which  they  can  enter  immediately  after  their  arrival 
at  home. 


ACROSS      THE      FIRING      LINE  209 

CHAPTER  XV 

ACROSS  THE  FIRING  LINE 

Prepared  as  she  was  for  war,  so  also  was  Germany  pre- 
pared for  the  consequences  of  war.  At  the  outbreak  of 
the  war,  she  had  of  all  other  countries  laid  the  most  solid 
foundation  for  the  care  of  the  crippled  soldier.  The 
German  national  Federation  for  the  Care  of  Cripples  is  an 
organization  of  long  standing.  There  had  been  devel- 
oped, during  half  a  century's  experience,  fifty-eight  crip- 
ple homes,  under  private  auspices,  ranging  in  size  from 
six  to  three  hundred  beds.  Some  of  them  were  already 
taking  adults  as  well  as  children,  and  they  had  among 
them  221  workshops,  teaching  51  trades.  In  addition, 
there  were  sanatoria  and  re-educational  workshops  for 
industrial  cripples  under  the  employers'  accident  insur- 
ance companies ;  there  were  orthopedic  hospitals  operated 
by  municipalities,  and  there  were  trade  schools  and 
employment  bureaus  under  various  government  auspices. 
All  these  resources  accumulated  in  peace  time  for  the 
rehabilitation  of  cripples  were  mobilized  immediately 
after  the  outbreak  of  the  war — almost  simultaneously 
with  the  military  mobilization.  Eight  days  after  the 
outbreak  of  hostilities,  the  Empress,  at  the  instance  of 
Dr.  Biesalski,  Germany's  leading  orthopedist  and  secre- 
tary of  the  national  Federation  for  the  Care  of  Cripples, 
addressed  to  existing  institutions  for  the  crippled  a  letter 
pointing  out  the  necessities  ahead  and  urging  them  to 
open  their  doors  and  provide  facilities  for  the  treatment 


210  THE      DISABLED      SOLDIER 

and  training  of  disabled  soldiers.  To  this  all  the  homes 
immediately  consented.  Dr.  Biesalski  undertook  a  tour 
of  Germany  and  visited  the  principal  cities  urging  the 
formation  of  voluntary  committees  for  the  care  of  war 
cripples.  The  immediate  result  was  the  formation  of 
volunteer  committees  in  many  cities  and  of  larger  ones 
in  some  states  and  provinces.  At  the  present  time, 
Germany  is  thoroughly  covered  by  a  network  of  such 
organizations.  A  local  committee  usually  comprises 
representatives  of  the  municipality,  of  the  military  dis- 
trict command,  the  accident  insurance  association,  the 
Red  Cross,  the  women's  leagues,  the  employers,  the 
chamber  of  commerce,  the  chamber  of  handwork,  and 
the  labor  unions.  In  the  fall  of  1915,  a  national  com- 
mittee was  formed  with  the  object  of  coordinating  the 
work  and  making  investigations  and  plans  for  the  future. 

There  are  four  stages  in  the  treatment  of  the  disabled 
soldier:  (1)  medical  treatment;  (2)  provision  of  artificial 
limbs  and  functional  re-education;  (3)  vocational  advice 
and  vocational  re-education;  and  (4)  placement.  Of 
these  activities,  the  first  two  are  controlled  by  the  im- 
perial military  authorities  and  are  conducted  on  uniform 
lines.  With  regard  to  vocational  and  economic  rehabili- 
tation, on  the  contrary,  there  is  no  general  direction  given 
by  any  central  authority;  the  re-education  schools  are 
of  varying  types  and  most  unevenly  distributed;  the 
work  is  in  the  hands  of  local  and  private  or  semi-private 
agencies;  it  is  done  mostly  by  volunteers  and  is  not  even 
supervised  by  the  imperial  government. 

However,  in  spite  of  the  absence  of  any  general  system 
of  organization,  there  is  a  complete  unity  of  purpose  and 
the  work  is  everywhere  carried  on  in  accordance  with 
certain   universally  accepted   and   officially  sanctioned 


The  Enemy  Conserves  Man  Power. 
German  at  work  with  a  draw  knife 


Disabled 


At  Work  Again — With  Four  Artificial  Limbs.     Germany  sees  to  it 
that  her  disabled  soldiers  are  prepared  for  self-support 


ACROSS      THE      FIRING      LINE  211 

principles.    These  were  formulated  by  Dr.  Biesalski  in 
this  way: 

1.  No  charity,  but  work  for  the  war  disabled. 

2.  Disabled  soldiers  must  be  returned  to  their  homes 
and  to  their  old  conditions;  as  far  as  possible,  to  their 
old  work. 

3.  The  disabled  soldier  must  be  distributed  among 
the  mass  of  the  people  as  though  nothing  had  happened. 

4.  There  is  no  such  thing  as  being  crippled,  while 
there  exists  the  iron  will  to  overcome  the  handicap. 

5.  There  must  be  the  fullest  publicity  on  this  subject, 
first  of  all  among  the  disabled  men  themselves. 

The  possibility  of  rehabilitation  is  accepted  as  a  creed 
by  all  the  institutions  working  to  this  end,  it  is  put  in 
practice,  and  the  statement  is  that  in  ninety  per  cent, 
of  the  cases  the  desired  results  are  attained. 

There  is  a  fairly  complete  network  of  orthopedic  homes 
distributed  all  over  the  empire.  Their  number  has  been 
put  at  about  two  hundred.  They  are  all  under  military 
discipline.  The  time  of  treatment  for  a  man  in  the  ortho- 
pedic hospital  is  from  two  to  six  months.  Men  are  kept 
here  until  they  are  ready  to  go  back  to  the  army  or  are 
pronounced  definitely  unfit  for  service.  Even  if  they  are 
so  unfit,  the  war  department  does  not  discharge  them 
until  they  are  pronounced  by  the  physician  physically 
fit  to  go  back  to  civil  life. 

The  best  hospitals  are  excellently  equipped.  Com- 
plaints have  been  made,  however,  that  the  remote  hos- 
pitals have  very  incomplete  arrangements  and  that  the 
great  demand  for  orthopedists  leaves  some  places  un- 
supplied. 

More  and  more  emphasis  is  being  placed  on  physical 
exercise  as  a  means  of  bringing  disabled  men  back  to  the 


212  THE      DISABLED      SOLDIER 

Standard.  The  plan  is  that  a  man  shall  begin  very 
simple  but  systematic  physical  exercises  even  before  he 
is  out  of  bed.  These  are  gradually  increased  until  finally 
he  has  two  or  three  hours  a  day  under  a  regular  gymna- 
sium instructor.  Games  and  outdoor  sports  are  found 
to  have  an  immense  therapeutic  value,  both  psycho- 
logical and  physiological,  as  compared  with  medico- 
mechanical  treatment.  Thus  we  find,  at  the  different 
hospitals,  as  part  of  the  regular  regime,  ball  playing, 
spear  throwing,  bowling,  shooting,  quoits,  hand  ball, 
jumping,  club  swinging,  and  swimming.  Finally,  though 
the  hospitals  do  not  attempt  to  train  a  man  to  a  trade, 
many  of  them  have  attached  workshops  for  purposes  of 
functional  re-education.  There  is  great  emphasis  placed 
on  the  fact  that  even  this  occupational  therapy  should 
be  really  useful  and  should  lead  the  patient  direct  to  some 
practical  occupation. 

All  artificial  limbs  are  furnished  and  kept  in  repair  by 
the  government.  The  government  has  prescribed  maxi- 
mum prices  for  prostheses  of  different  types.  Otherwise 
there  is  no  official  supervision.  No  standard  pattern  is 
prescribed,  and  the  matter  is  left  to  the  doctors  and  en- 
gineers of  the  country.  The  result  is  an  immense  stimu- 
lation of  activity.  The  magazines  are  full  of  descriptions 
of  new  prostheses  recommended  by  doctors  and  manual 
training  teachers  from  all  parts  of  the  country.  At  an 
exhibition  of  artificial  limbs,  held  at  Charlottenburg, 
there  were  shown  thirty  kinds  of  artificial  arms  and  fifty 
types  of  artificial  legs  in  actual  use. 

The  principle  now  thoroughly  accepted  is  that  the 
prosthesis  should  reproduce  not  the  lost  limb  but  the 
lost  function.    It  should  not  be  an  imitation  arm  or  leg, 


ACROSS      THE      FIRING     LINE  213 

but  a  tool.  The  standard  of  merit  is  the  number  of 
activities  it  makes  possible. 

Re-education  in  Germany  goes  on  at  the  same  time  as 
the  medical  treatment.  This  has  two  causes.  First, 
there  is  the  strong  conviction  among  all  cripple  welfare 
workers  that  results  can  be  obtained  only  by  getting 
hold  of  a  patient  at  the  earliest  possible  moment  of  con- 
valescence, and  second,  the  fact  that,  since  the  govern- 
ment does  not  pay  anything  towards  re-education,  it  is 
more  economical  for  the  care  committees  to  attend  to 
it  while  the  men  are  in  the  hospitals  and  thus  save  them- 
selves the  expense  of  maintenance. 

The  first  civilian  function  in  the  care  of  the  war  cripples 
is  vocational  advice.  The  local  care  committee  usually 
appoints  vocational  advisers,  which  appointments  have 
to  be  sanctioned  by  the  local  military  authorities,  who 
control  the  visits  to  the  men  in  the  hospitals.  As  soon 
as  a  soldier  is  well  enough  to  be  visited,  the  committee 
sends  a  representative  to  get  full  data  on  his  experience 
and  his  physical  condition,  and  then  advise  him  as  to 
re-education  or  immediate  return  to  work.  The  prin- 
ciple is  fast  held  to  that  a  man  must,  if  humanly  possible, 
go  back  to  his  old  trade,  or,  failing  that,  to  an  allied  one. 

The  trade  training  is  given  while  the  men  are  still  in 
the  military  hospital,  beginning,  in  fact,  as  soon  as  they 
are  able  to  be  out  of  bed.  The  workshops  are  maintained 
by  the  local  care  committees ;  they  can  be  located  either 
in  the  hospital,  or  at  an  outside  point  to  which  the  men 
go  every  day.  The  first  plan  is  followed  by  but  a  few 
of  the  larger  institutions;  in  most  instances  there  are 
no  workshops  maintained  at  the  hospitals.  The  local 
care  committee  may  utilize  the  local  trade  schools. 
There  are  excellent  facilities  for  this,  since  every  town 


214  THE      DISABLED      SOLDIER 

has  at  least  one  trade  school.  Some  representative  of 
the  educational  authorities  generally  serves  on  the  local 
care  committee  and  the  schools  are  eager,  in  any  case, 
to  offer  free  instruction.  German  magazines  are  full  of 
advertisements  of  free  courses  for  war  cripples,  offered 
by  schools  of  the  most  varying  kind,  public  and  private, 
from  agricultural  and  commercial  schools  to  professional 
schools  and  universities.  On  the  other  hand,  in  a  large 
town,  with  a  number  of  hospitals,  the  committee  may 
create  a  school  of  its  own.  Thus,  in  Diisseldorf,  for 
instance,  where  there  are  fifty  hospitals,  the  committee 
has  taken  possession  of  a  school  building  equipped  with 
shops  and  tools  and  given  twenty  courses  open  to  men 
from  all  the  hospitals. 

It  is  planned  that  none  of  the  courses  shall  take  more 
than  six  months,  the  maximum  time  for  hospital  care. 
These  short  courses  are  intended  for  men  of  experience 
who  need  further  practice  in  their  old  trade  or  in  an 
allied  one.  If  a  man  needs  further  training  after  this 
short  course,  he  becomes  the  charge  of  the  local  care 
committee,  which  supports  him  while  he  attends  a  tech- 
nical school  or  pays  the  premium  for  apprenticing  him 
to  a  master  workman. 

A  special  effort  is  being  made  to  return  to  the  land  all 
who  have  any  connection  with  it,  such  as  farmers,  farm 
laborers,  and  even  hand-workers  of  country  birth.  All 
the  hospitals  which  have  any  land  give  courses  in  farming 
and  gardening  for  their  patients.  It  is  estimated  that 
there  are  several  hundred  such  hospital  farms,  small  or 
large,  operated  by  the  wounded.  In  addition  to  this, 
there  are  definite  summer  farm  courses  at  agricultural 
schools  and   universities,   which   are   free    to   cripples. 


ACROSS      THE      FIRING      LINE  215 

There  are  in  the  empire  ten  regular  agricultural  schools 
for  war  cripples. 

Since  the  one-armed  man  has  one  of  the  gravest  handi- 
caps, special  arrangements  have  been  made  in  several 
places  for  his  training.  The  purpose  of  these  courses  for 
the  one-armed  is  to  accustom  the  soldier  to  exercise  the 
stump  and  the  remaining  member,  performing  the  daily 
duties  such  as  eating,  washing,  dressing,  tying  knots, 
using  simple  tools,  and  the  like.  This  is  a  preliminary 
to  specialized  trade  training,  and  the  process  is  said 
usually  to  require  about  six  weeks. 

An  essential  feature  of  the  course  is  left-handed  writing 
for  those  who  have  lost  the  right  arm,  not  only  for  men 
in  preparation  for  clerical  work  but  for  others  as  well. 
This  training  banishes  to  a  marked  degree  the  feeling 
of  helplessness  and  likewise  gives  the  hand  greater  flexi- 
bility and  skill.  German  teachers  have  made  a  scientific 
study  of  this  question  and  state  that  left-handed  writing 
can  be  made  as  legible  and  characteristic  as  right- 
handed.  Samples  of  left-handed  writing  from  Nurnberg 
show  excellent  script  after  from  twelve  to  twenty  lessons. 

Left-handed  drawing,  designing,  and  modeling  are 
often  added  subjects  of  instruction.  Men  with  clerical 
experience  are  taught  to  use  the  typewriter,  sometimes 
using  the  stump,  sometimes  a  special  prosthesis,  and 
sometimes  with  a  shift  key  worked  with  the  knee. 

All  the  schools  for  one-armed  put  great  emphasis  on 
physical  training.  In  the  school  at  Heidelberg,  under  a 
regular  gymnasium  instructor,  the  men  do  almost  all  the 
athletic  feats  possible  to  two-armed  men. 

There  is  no  uniform  machinery  for  the  placement  of 
war  cripples.  The  care  committees,  while  interviewing 
the  man  in  the  hospital,  also  get  in  touch  with  his  former 


216      THE  DISABLED  SOLDIER 

employer.  Sometimes  a  position  is  thus  secured  even 
before  the  man  has  started  his  training,  and  the  latter 
is  then  adapted  to  the  requirements  of  that  particular 
position.  But  it  is  not  always  possible  to  place  a  man 
with  his  old  employer.  Some  of  the  larger  care  com- 
mittees run  employment  bureaus  of  their  own.  Others 
turn  over  to  some  other  agency  the  man  who  cannot  be 
taken  back  to  his  old  position — usually  to  the  regular 
employment  bureaus.  Germany  has  a  system  of  public 
employment  bureaus  supported  by  the  municipalities. 
The  bureaus  in  each  state  or  province  are  united  under 
a  state  or  provincial  directorate,  and  the  directorates  in 
an  imperial  federation.  Some  of  these  had,  before  the 
war,  special  divisions  for  the  handicapped,  and  others 
have  established  them  since  the  outbreak  of  hostilities. 
Employers'  and  workmen's  associations  are  of  consider- 
able assistance  in  the  placement  of  war  cripples,  especially 
the  Federation  of  German  Employers'  Associations,  which 
has  been  recently  formed  for  this  particular  purpose,  and 
the  many  master  guilds  of  handworkers.  There  are  also 
a  number  of  agencies  due  to  charitable  or  private  ini- 
tiative. 

Finally,  there  are  open  to  war  cripples  a  very  large 
number  of  jXDsitions  in  government  service.  The  imperial 
government  has  promised  that  all  former  employees  of 
the  railways,  postoffice,  and  civil  service  will  be  re- 
employed, if  not  in  their  old  capacity,  in  a  kindred  posi- 
tion. These  men  are  to  be  paid  without  consideration 
of  their  pensions.  The  postofifice  department  has  decided 
to  give  all  future  agencies  and  sub-agencies  in  the  rural 
districts  to  war  cripples,  provided  they  are  fit  for  the 
positions  and  want  to  settle  on  the  land.  Many  city 
governments  make  efforts  to  take  in  cripples.    There  are 


ACROSS      THE      FIRING      LINE  217 

reserved  for  cripples  a  number  of  employments  under 
the  war  department,  which  through  its  recently  created 
welfare  department  attempts  also  to  develop  placement 
activity  wherever  there  is  no  very  active  local  care  com- 
mittee, publishing  twice  a  week  a  journal  which  lists 
positions  open  for  war  cripples. 

Both  in  Austria  and  in  Hungary,  re-education  is  ob- 
ligatory and  entirely  controlled  by  the  government.  The 
respective  functions  of  the  military  and  the  civil  authori- 
ties, with  regard  to  the  care  of  the  disabled,  have  been 
delimited  as  follows.  The  military  authorities  provide 
the  wounded  with  the  first  medical  assistance,  bear  the 
cost  of  manufacturing  and  repairing  artificial  limbs  as 
long  as  the  patient  stays  in  military  service,  meet  the 
cost  of  the  treatment  in  non-military  institutions,  keep 
the  wounded  under  control  until  recovery  of  earning  ca- 
pacity or  until  discharged  as  an  invalid.  After-treatment 
and  vocational  re-education  are  controlled  jointly  by  the 
military  and  civil  authorities.  Placement  is  entirely 
under  civilian  auspices. 

The  civilian  part  of  the  work  is  controlled  by  the 
Ministry  of  the  Interior.  However,  in  view  of  the  great 
variety  of  linguistic  and  economic  conditions  in  the  em- 
pire, the  Ministry  has  entrusted  the  care  of  invalids  to 
the  several  provincial  governments.  In  the  capital  of 
each  province  a  provincial  commission  was  created,  for 
the  purpose,  among  other  things,  of  providing  medical 
care  and  vocational  re-education  for  war  invalids  of  the 
province,  and  of  creating  the  necessary  machinery  for 
placement,  to  administer  which  an  official  employment 
bureau  has  been  created  at  every  provincial  capital. 

The  largest  Austrian  institution  for  the  care  of  war 
invalids  is  the  so-called  Reserve  Hospital  No.   11,  in 


218  THE      DISABLED      SOLDIER 

Vienna.  It  comprises  both  an  orthopedic  hospital  and 
training  school.  The  hospital,  which  is  excellently 
equipped,  receives  wounded  soldiers  whose  wounds  have 
been  completely  healed,  and  gives  them  reconstructive 
treatment.  At  the  same  time  those  who  require  pros- 
thetic appliances  are  trained  in  using  them. 

After  having  completed  the  preliminary  orthopedic 
treatment,  every  patient  is  assigned  to  a  workshop.  The 
workshops  were  at  first  established  in  a  public  school. 
But  later  a  garden  city  was  created,  consisting  of  forty- 
two  barracks,  with  a  hundred  men  in  each.  The  shops 
are  now  distributed  among  these  barracks. 

Altogether  about  thirty  trades  are  taught,  mostly  small 
handicrafts,  such  as  can  be  carried  on  in  small  rural  local- 
ities. The  most  important  subjects  of  instruction  are 
the  following:  wood  work  (cabinet-making,  turning,  car- 
pentry), metal  work  (locksmithing,  blacksmithing,  braz- 
ing, electrical  work),  bookbinding,  basket-making,  paint- 
ing, masonry,  plastering,  leather  work  (harness-making, 
purse-making,  orthopedic  appliances) ,  tailoring,  and  shoe- 
making.  In  addition  to  the  manual  trades,  there  are 
courses  in  bookkeeping,  typewriting,  arithmetic,  and 
drawing.  A  course  in  agriculture  is  likewise  given. 
There  has  been  put  at  the  disposition  of  the  hospital  a 
private  estate,  on  which  practical  farm  training  in  agri- 
culture is  carried  on  under  the  direction  of  a  physician 
and  of  a  one-armed  teacher. 

The  first  object  of  the  re-education  is  always  to  return 
the  man  to  his  former  trade,  and,  according  to  report, 
this  result  is  attained  in  all  but  one  case  in  twenty. 
Whenever  the  man  can  satisfactorily  be  restored  to  his 
former  occupation,  or  when  he  has  to  be  adapted  to  some 
less  arduous  work  in  the  same  line,  his  re-education  is 


ACROSS      THE      FIRING      LINE  219 

completed  in  the  hospital  school.  But  in  the  case  of  men 
being  trained  for  a  more  skilled  position  in  their  own 
trade,  or  being  taught  an  entirely  new  vocation — espe- 
cially the  young  soldiers  who  have  never  before  had  any 
industrial  training — the  courses  given  in  the  hospital 
schools  are  purely  preparatory.  Their  purpose  is  to  com- 
plete the  functional  restoration  of  the  man,  to  find  for 
him  the  most  suitable  occupation,  and  to  accustom  him 
to  the  use  of  his  prosthesis.  The  specialization  in  skilled 
trades  is  left  to  other  institutions,  mainly  to  the  regular 
vocational  schools,  which,  through  the  cooperation  of  the 
Ministry  of  Public  Works  and  of  the  various  trade  asso- 
ciations, offer  special  facilities  for  the  training  of  men 
graduated  from  the  hospital  schools. 

The  schools  for  invalids  are  under  military  control,  but 
their  administration  is  jointly  civilian  and  military.  Be- 
sides the  "medical  director,"  who  is  a  member  of  the 
medical  corps,  there  is  a  "technical  director,"  appointed 
by  the  Ministry  of  Public  Works.  These  two  officials 
act  cooperatively  as  vocational  advisers. 

The  patient  leaves  the  institution  only  when  he  Is  able 
to  return  either  to  the  army  or  to  his  former  occupation 
in  civil  life.  In  the  latter  case,  he  is  not  discharged  until 
the  hospital  finds  for  him  regular  employment.  In  pro- 
curing employment,  the  hospital  cooperates  with  the 
public  employment  office  of  Vienna,  to  which  it  details 
its  own  physicians,  and  a  representative  of  the  Ministry 
of  Public  Works.  In  the  case  of  independent  landowners 
or  craftsmen,  the  hospital,  before  discharging  them, 
makes  inquiry  to  ascertain  whether  their  prospective 
income  is  sufficient  to  their  support.  A  register  of  all 
men  discharged  is  kept  by  the  hospital,  and  their  place  of 
employment  and  earnings  are  recorded  from  time  to  time. 


220 THE      DISABLED      SOLDIER 

The  general  tendency  in  Austria  has  been  to  establish 
large  size  institutions,  on  the  Vienna  model,  and  to  locate 
them  in  principal  cities,  of  which  there  are  relatively  few 
in  Austria.  By  the  end  of  1915,  institutions  for  crip- 
pled soldiers  existed  in  Prague,  Reichenberg,  Troppau, 
Teschen,  Graz,  Cracow,  Linz,  Mehr-Ostran,  and  in  some 
of  the  other  large  industrial  cities. 

In  Hungary,  provision  for  disabled  soldiers  was  organ- 
ized under  several  decrees  issued  in  September,  1915. 
The  work  was  put  in  charge  of  a  Royal  Office  for  the  Dis- 
abled. The  decrees  provide  that  orthopedic  appliances 
shall  gratuitously  be  supplied.  Re-education  of  disabled 
soldiers  in  their  former  occupation  or  a  new  one  is  ob- 
ligatory. The  treatment  and  re-education  are  not  to  last 
more  than  one  year. 

Special  re-examination  commissions  were  established 
at  Budapest,  Pressburg,  Kolozsvar,  and  Zagreb,  the  chair- 
men and  members  being  appointed  by  the  Premier  from 
medical  and  industrial  circles.  Invalids  refusing  to  use 
prostheses,  to  submit  to  the  treatment,  or  to  take  ad- 
vantage of  the  re-education  offered,  must  appear  before 
these  commissions.  Those  who  persist  in  refusal,  in  spite 
of  the  findings  of  the  commission,  forfeit  all  or  part  of 
their  claim  to  a  pension,  excepting  only  those  who  have 
been  in  active  military  service  for  ten  years  or  more. 

The  Office  for  the  Disabled,  in  collaboration  with  the 
War  Ministry,  keeps  record  of  all  soldiers  incapacitated 
for  military  service  and  requiring  medical  care.  It  con- 
trols all  hospitals  for  the  treatment  of  disabled  soldiers, 
all  training  schools,  all  shops  manufacturing  prostheses 
and  artificial  limbs,  and  all  agricultural  and  industrial 
training  institutions.    It  supports  and  supervises  all  pri- 


ACROSS      THE      FIRING      LINE  221 

vate  institutions  caring  for  the  disabled,  and  also  manages 
the  employment  service. 

The  institutions  under  the  control  of  the  Office  for  the 
Disabled  are  officially  divided  in  three  classes:  (1)  insti- 
tutions for  medical  care;  (2)  shops  for  the  manufacture 
of  prostheses ;   (3)  schools  for  invalids. 

The  men  are  assigned  to  the  different  medical  institu- 
tions by  the  military  authorities.  They  are  received  and 
discharged  by  the  director,  upon  report  by  a  commission 
of  officials  of  the  hospital. 

All  the  medical  institutions  were  created  anew.  Or- 
ganization began  at  Budapest  with  four  hospitals  for 
4,500  patients;  by  the  middle  of  1916  there  was  accom- 
modation for  over  10,000  in  the  hospitals  of  that  city 
alone.  In  addition  to  those  at  Budapest,  similar  insti- 
tutions were  established  at  Pressburg,  Kolozsvar,  Kassa, 
and  several  other  cities. 

Private  or  commercial  initiative  failed  to  provide  an 
adequate  supply  of  artificial  limbs.  The  Office  for  the 
Disabled,  therefore,  established  shops  for  the  manufac- 
ture of  prostheses  at  the  metal  trades  schools  of  Budapest 
and  Pressburg.  The  work  is  done  either  by  invalids  or 
by  soldiers  detailed  by  the  military  authorities.  In  the 
spring  of  1916  there  came  into  being  a  permanent  state 
factory  for  the  replacement  and  repair  of  artificial  limbs. 

Among  the  schools  for  the  disabled,  the  largest  is  that 
at  Budapest,  which  had  700  pupils  at  the  beginning 
of  1916.  Almost  ninety  per  cent,  of  the  pupils  are 
peasants.  The  primary  object  of  the  re-education  is  to 
train  independent  craftsmen.  The  classes  having  the 
greatest  numbers  of  pupils  are  those  for  shoemakers, 
tailors,  harness-makers,  cartwrights,  locksmiths,  and 
cabinet-makers. 


222  THE      DISABLED      SOLDIER 

Similar  schools  are  found  in  Pressburg,  Kassa,  and 
Kolozsvar.  Alongside  of  the  vocational  training,  instruc- 
tion in  reading  and  writing  is  given  to  illiterates.  Those 
who  have  interrupted  their  elementary  or  highschool 
education  are  given  an  opportunity  to  continue  it.  In 
some  of  the  schools  instruction  is  also  given  in  type- 
writing, stenography,  and  bookkeeping. 

At  Budapest,  at  the  Institute  for  the  Blind,  which  has 
apprbximately  140  patients,  blind  soldiers  are  taught 
carpet-making,  brush-making,  massage,  and  the  like. 

For  the  benefit  of  those  men  so  disabled  that  they 
cannot  be  placed  in  regular  factories  or  mercantile  con- 
cerns, special  cooperative  shops  have  been  created. 

It  seems  that  while  the  work  in  its  medical  aspects 
ranks  high,  the  vocational  and  economic  aspects  have 
been  rather  neglected.  Thus,  the  regular  vocational 
schools  have  not  been  utilized  for  the  re-education  of 
invalids;  nor  has  any  opportunity  been  taken  of  the 
different  industrial  organizations  and  trade  associations. 
Very  little  has  been  done  in  the  way  of  training  in  agri- 
culture. The  employment  service  of  the  Office  for  the 
Disabled  seems  to  be  organized  in  a  rather  bureaucratic 
way,  no  cooperation  has  been  asked  of  either  local  or 
trade  organizations,  and  no  vocational  advisers  are  em- 
ployed. 

In  spite  of  their  preparation,  In  spite  of  their  fore- 
warning, the  Central  Powers  still  have  far  to  go  in  making 
adequate  provision  for  the  soldiers  disabled  in  their  grasp 
after  world  empire. 


FOR      THE      U.      S.      FORCES 223 

CHAPTER  XVI 

FOR  THE  U.  S.  FORCES 

The  situation  of  the  United  States  with  regard  to  making 
provision  for  the  disabled  soldier  is  perhaps  slightly 
different  from  that  of  the  other  belligerents.  One  of 
the  principal  causes  of  difference  is  the  selective  influence 
on  the  personnel  of  the  military  forces  of  the  conscrip- 
tion law. 

This  legislation  has  specifically  exempted,  temporarily 
at  any  rate,  agricultural  workers,  highly  skilled  mechanics, 
and  those  who,  because  of  their  special  qualifications, 
are  necessary  to  the  maintenance  of  the  national  interest 
at  home.  In  Italy  and  France  the  situation  with  regard 
to  the  make-up  of  the  army  is  vastly  different.  There 
we  find  almost  all  the  able-bodied  agricultural  workers 
in  the  service,  and  battalions  of  highly  skilled  mechanics 
and  experienced  workmen  in  uniform. 

The  problem  of  refitting  for  industry  the  disabled 
soldiers  of  the  European  forces  is  therefore  very  unlike 
that  of  the  United  States.  Up  to  the  present  time  the 
force  sent  to  the  front  consists  practically  of  men  between 
the  ages  of  twenty-one  and  thirty-one.  This  means  that 
the  majority  of  men  disabled  will  not  be  highly  skilled 
or  long  experienced  in  any  occupation  and  thus  will  be 
more  plastic  from  the  vocational  point  of  view.  Past 
experience  has  in  European  practice  been  the  main  deter- 
minant of  training  for  the  future.  It  may  be  expected 
that  in  many  of  the  American  cases  this  will  afford  no 
definite  criterion.    Either  the  soldier  may  have  entered 


224  THE      DISABLED      SOLDIER 

the  service  direct  from  school  or  college  or  if  he  has  been 
at  work  for  some  time,  it  is  likely  to  have  been  in  a  dozen 
different  jobs  of  varying  character.  Many  of  the  men, 
therefore,  can  answer  definitely  to  no  "former  occu- 
pation." As  has  been  found  in  Canadian  experience, 
the  soldier  when  asked  his  trade  will  report  that  for 
three  months  prior  to  the  war  he  worked  on  a  railroad. 
"Then  you  are  a  railroad  man?"  is  the  question.  "No," 
is  the  answer,  "for  the  two  months  before  that  I  was  in 
a  cotton  mill,  and  still  earlier  drove  a  delivery  wagon 
for  a  local  firm."  In  such  a  case  past  experience  is  almost 
a  negligible  factor,  and  the  man  may  properly  be  re- 
studied  vocationally  in  order  that  he  may  be  trained  in 
the  skilled  trade  most  suited  to  his  qualifications  and 
talents. 

An  interesting  experiment  in  vocational  analysis  and 
allocation  has  been  carried  out  by  the  military  authori- 
ties in  classifying  drafted  men  for  special  lines  of  army 
service.  The  new  recruits  have  been  given  simple  psy- 
chological tests  prior  to  their  assignment  to  work  as 
radio  operators,  oxy-acetylene  welders,  linemen  in  the 
signal  corps,  drivers  or  mechanicians  in  the  motor  trans- 
port service,  and  so  forth.  The  results  have  been  en- 
couraging and  the  experience  gained  will  undoubtedly  be 
helpful  in  further  vocational  guidance  of  the  men  re- 
turning for  discharge. 

In  the  general  process,  it  is  likely  that  many  men  who 
were  previously  undifferentiated  as  to  occupation,  who 
possibly  looked  forward  to  careers  as  clerks  or  general 
utility  men,  may  be  directed  into  skilled  trades  which 
will  afford  to  them  a  much  greater  financial  opportunity, 
and  will  contribute  more  largely  to  the  national  stability 
and  efficiency. 


FOR      THE      U.      S.      FORCES 225 

The  recent  wave  of  interest  in  the  United  States  in 
vocational  education  has  put  the  country  in  better  shape 
to  deal  with  the  instructional  requirements  of  the  dis- 
abled soldier  than  would  have  been  the  case  ten  years 
ago.  Although  not  claiming  facilities  to  compare  with 
those  afforded  by  the  fine  system  of  technical  institutes 
in  Great  Britain,  there  are  in  practically  every  important 
urban  community  of  America,  one  or  more  vocational 
schools.  Industrial  education  is  well  provided  for  by 
schools,  the  first  of  which  were  founded  by  private  ini- 
tiative but  operated  on  a  non-commercial  basis.  The 
later  institutions  have  been  established  by  local  educa- 
tional authorities  as  part  of  the  public  school  systems. 

Commercial  education,  to  a  noteworthy  extent,  is  still 
in  the  hands  of  business  colleges  which  are  run  as  profit- 
making  enterprises.  But  the  work  of  many  of  them  is 
efficient  to  a  creditable  degree. 

Agricultural  education  has  been  splendidly  provided  for 
by  the  agricultural  colleges  and  experiment  stations  main- 
tained by  the  several  states,  with  assistance,  in  some  in- 
stances, from  the  national  government.  These  institutions 
have  the  most  modern  equipment,  expert  teaching  staffs, 
and  the  finest  facilities  for  imparting  a  practical  knowl- 
edge of  agriculture. 

And  finally,  it  must  be  recalled  that  practically  every 
American  university  has  industrial  departments  with 
shop  equipment,  which  afford  to  students  not  only  the 
theoretical,  but  also  the  practical,  type  of  instruction. 
As  the  war  goes  on  the  universities  will  be  drained  of 
students,  while  the  vocational  schools  whose  regular 
pupils  are  of  younger  age,  will  tend  to  continue  full.  In 
Canada  the  university  plants  have  been  put  to  good 
use  in  the  training  of  disabled  soldiers.     Even  more 


226  THE      DISABLED      SOLDIER 

extensive  facilities  of  this  character  are  available  in  the 
United  States. 

Prior  to  the  entry  of  America  into  the  war  there  had 
been  almost  no  provision  for  rehabilitation  of  the  dis- 
abled adult.  There  had  been  several  employment  bureaus 
for  cripples,  in  New  York,  Boston,  Cincinnati,  and  Phila- 
delphia. These  agencies  had  been  struggling  bravely, 
without  recourse  to  training  facilities,  and  with  scant 
public  support,  to  solve  the  economic  problems  of  the 
disabled,  and  were  attaining  an  encouraging  degree  of 
success.  About  five  years  previous  there  had  been 
started,  but  later  discontinued,  a  training  school  for 
crippled  men. 

So  in  spite  of  the  excellent  foundation  of  general  voca- 
tional education  the  United  States,  at  her  entrance  into 
hostilities,  stood  practically  without  special  facilities  for 
the  re-education  of  the  disabled.  The  need  of  such 
special  provision  had  been  long  recognized  by  workers 
with  the  handicapped  and  was  repeatedly  discussed  in  a 
special  journal  on  cripples  which  was  their  organ. 

The  first  move  to  meet  this  need  was  taken  the  second 
month  after  America's  declaration  of  war,  when  a  public- 
spirited  citizen  offered  to  the  American  Red  Cross  funds 
sufficient  to  establish  and  maintain  in  New  York  City 
a  training  school  for  crippled  men.  While  an  original 
motive  of  the  gift  was  a  desire  to  make  provision  which 
might  be  helpful  to  the  disabled  American  soldier,  the 
school  was  started  for  crippled  men  in  general,  without 
distinction  as  to  their  civilian  or  military  affiliation. 
Thus  came  into  being  the  Red  Cross  Institute  for  Crip- 
pled and  Disabled  Men. 

It  became  soon  evident  that  this  organization  had 
logical  responsibilities  much  wider  in  scope  than  the 


FOR      THE      U.      S.      FORCES  227 

conduct  of  a  local  school  of  re-education.  Legislation 
making  government  provision  for  the  training  of  disabled 
soldiers  did  not  appear  on  the  statute  books  until  fourteen 
months  after  the  inception  of  hostilities,  so  for  a  con- 
siderable period  there  was  no  official  agency  to  which 
to  turn  for  information  and  advice.  Yet  there  was  wide 
interest  in  provision  for  the  disabled  soldier.  To  meet 
demands  from  the  public  for  data  on  the  organization, 
methods,  and  principles  of  re-education,  as  derived  from 
experience  abroad,  and  to  provide  a  scientific  foundation 
for  the  development  of  its  own  activities,  the  Institute 
initiated  in  July,  1917,  a  department  of  research.  There 
was  early  issued  a  bibliography  of  the  subject,  followed 
by  reports  on  activity  in  different  countries,  monographs, 
and  translations,  which  have  been  freely  distributed  for 
the  information  of  all  interested  in  the  subject. 

This  Institute,  which  undertook  at  once  the  training 
of  crippled  industrial  workers,  has  established  courses  in 
the  manufacture  of  artificial  limbs,  oxy-acetylene  welding, 
printing,  motion  picture  operating,  jewelry-making,  and 
mechanical  drafting.  There  are  also  departments  of 
employment,  industrial  surveys,  and  public  education. 

During  the  incubation  of  the  national  program  the 
Red  Cross  Institute  for  Crippled  and  Disabled  Men  thus 
served  as  an  experiment  station  and  proving  ground, 
and  unofficially  met  demands  upon  it  to  the  best  of  its 
ability. 

In  the  formulation  of  the  government  plans  there  was 
considerable  difference  of  opinion  as  to  what  authority 
or  authorities  should  be  charged  with  the  responsibility 
of  re-educating  the  disabled  soldier.  It  was  urged  on 
the  one  hand  that  the  entire  task  of  rehabilitation  in  all 
its  aspects  should  be  entrusted  to  the  Surgeon  General 


228  THE      DISABLED      SOLDIER 

of  the  Army;  on  the  other  hand  that  it  might  be  handled 
by  the  Bureau  of  War  Risk  Insurance — a  government 
department  administering  family  allotments  and  allow- 
ances and  the  new  life  and  disability  insurance,  privilege 
of  which  was  offered  to  men  entering  upon  military 
service.  A  later  suggestion  advanced  by  the  Council  of 
National  Defense  was  that  re-education  be  entrusted  to 
a  commission  under  the  War  Department,  made  up  of 
representatives  of  all  the  official  and  non-official  interests 
concerned.  Another  proposal  which  was  approved  by 
a  conference  called  by  the  Surgeon  General  of  the  Army 
at  the  instance  of  the  Secretary  of  War,  and  which  was 
embodied  in  the  draft  of  a  legislative  proposal,  called 
for  an  independent  commission  of  five,  composed  of  rep- 
resentatives of  the  Surgeon  General  of  the  Army,  the 
Surgeon  General  of  the  Navy,  the  Treasury  Department, 
the  Department  of  Labor,  and  the  Federal  Board  for 
Vocational  Education. 

The  Administration  felt,  however,  the  unwisdom  of 
erecting  more  independent  boards  or  commissions  un- 
related to  the  regular  executive  mechanism.  For  this 
reason  it  was  decided  to  fix  the  task  on  some  already 
existing  government  department.  The  one  designated 
in  legislation  introduced  with  executive  approval,  and 
later  enacted,  assigned  the  responsibility  of  providing  for 
the  rehabilitation  of  the  disabled  soldier  and  sailor  to  the 
Federal  Board  for  Vocational  Education,  a  body  which 
had  been  created  a  year  earlier  to  administer  federal  aid 
to  vocational  education  by  the  states.  The  bill  com- 
mitting this  new  function  to  the  Board  became  law  on 
June  27,  1918. 

Meantime,  the  Surgeon  General  of  the  Army  had  been 
establishing  reconstruction  hospitals  for  the  intensive 


FOR      THE      U.      S.      FORCES  229 

treatment  of  physical  disablement.  In  connection  with 
each  of  these  medical  centers  educational  work  had  been 
undertaken — with  three  ends  in  view.  The  first  was  to 
provide  to  convalescent  patients  occupation  for  thera- 
peutic purposes;  the  second  to  provide  educational 
opportunities  during  the  period  of  invalidism  to  men 
who  would  be  returned  to  the  front  or  discharged  without 
permanent  disability;  the  third  to  train  disabled  men 
whom  it  was  desired  to  retain  in  the  military  organization 
for  special  or  limited  service.  In  carrying  out  the  two 
latter  aims,  the  educational  departments  of  the  hospitals 
have  entered  well  within  the  vocational  field. 

Important  links  in  the  military  hospital  chain  are  the 
reception  hospitals  at  Fox  Hills,  Staten  Island,  N.  Y.; 
at  Ellis  Island,  in  New  York  harbor;  and  at  Newport 
News,  Va.  At  these  institutions  there  are  first  received 
from  hospital  ships  or  transports  all  soldiers  invalided 
home  from  overseas.  The  men  are  classified  as  to  treat- 
ment need  and  district  of  residence,  and  promptly 
"cleared"  to  the  appropriate  institution. 

During  the  period  of  hospital  or  convalescent  care 
the  soldier  has  advantage  of  physical  and  occupational 
therapy  administered  by  a  corps  of  trained  workers 
known  as  "reconstruction  aides"  but  more  familiarly 
named  "blue  gowns"  on  account  of  their  uniform. 

Classes  in  the  various  military  hospitals  have  already 
been  established.  The  subjects  taught  at  General  Hos- 
pital No.  6,  Fort  McPherson,  Atlanta,  Ga.,  for  example, 
are  motor  mechanics,  telegraphy,  wireless  telegraphy, 
typewriting,  mechanical  drafting,  cabinet-making,  car- 
pentry, harness  repairing,  poultry  raising,  reading  and 
writing  English,  penmanship  and  bookkeeping,  and 
printing. 


230  THE      DISABLED      SOLDIER 

When  a  candidate  for  discharge  from  the  military 
forces  is  so  disabled  as  to  entitle  him  to  compensation 
for  disability,  his  case  is  discussed  with  him,  while  he  is 
still  in  the  hospital,  by  a  vocational  adviser  of  the  Fed- 
eral Board  for  Vocational  Education.  He  is  told  that 
the  United  States  Government  will  train  him  free  of 
charge  for  a  new  trade.  It  is  entirely  optional  with  the 
man  whether  he  take  advantage  of  this  opportunity  for 
training  or  not,  but  every  influence  is  brought  to  bear 
to  make  his  decision  affirmative. 

After  the  disabled  man  is  discharged  from  the  hospital, 
he  becomes  a  civilian  and  his  dealings  are  with  the 
Federal  Board  and  the  Bureau  of  War  Risk  Insurance. 

If  the  man  decides  to  take  a  course  of  training,  he  is 
supported  during  the  period  of  re-education  through 
payment  by  the  Bureau  of  War  Risk  Insurance  of  his 
compensation  for  disability  or  his  former  military  pay, 
whichever  is  the  greater.  During  this  period  the  com- 
pulsory allotments  and  allowances  to  his  dependents  are 
continued  just  as  if  he  were  still  in  military  service.  He 
is  given  instruction  that  is  paid  for  and  supervised  by 
the  Federal  Board  for  Vocational  Exiucation  in  one  of 
the  schools  approved  by  that  body. 

The  Federal  Board  for  Vocational  Education  has  an- 
nounced that  its  provision  of  re-education  will  be  made, 
so  far  as  possible,  through  the  use  of  existing  schools,  or 
by  placement  for  training,  under  a  modified  system  of 
apprenticeship,  with  manufacturing  or  commercial  estab- 
lishments. Special  institutions  will  be  founded  only 
where  absolutely  necessary. 

The  Board  is  establishing  district  offices  to  decentralize 
the  work,  is  making  training  arrangements  for  current 
cases,  and  is  following  up  to  their  homes  men  who  were 


FOR      THE      U.      S.      FORCES  231 

discharged  from  the  army  prior  to  the  inception  of  re- 
educational  activity,  and  who  stand  in  possible  need  of 
training.  Local  offices  are  already  in  operation  in  New 
York,  Boston,  Philadelphia,  Cincinnati,  Atlanta,  Wash- 
ington, D.  C,  New  Orleans,  Minneapolis,  Chicago,  St. 
Louis,  Dallas,  Denver,  San  Francisco,  and  Seattle. 

After  training  is  complete,  the  re-educated  soldier  will 
be  placed  in  a  job  by  the  Federal  Board,  acting,  as  pro- 
vided by  the  law,  in  cooperation  with  the  United  States 
Employment  Service  of  the  Department  of  Labor.  The 
Board  also  includes  in  its  placement  function  any  man 
physically  rehabilitated  in  an  army  or  navy  hospital, 
whether  he  be  a  candidate  for  retraining  or  not. 

The  American  Red  Cross  has  offered  to  the  govern- 
ment authorities  the  facilities  of  its  extensive  home 
service  organization  throughout  the  country.  This 
service,  directed  by  the  Department  of  Civilian  Relief, 
can  help  to  align  the  family  as  an  encouraging  force 
behind  the  re-education  program,  can  keep  the  family 
wheels  moving  smoothly  during  the  period  of  training, 
can  provide  to  the  vocational  officers  much  useful  infor- 
mation on  the  home  conditions  and  community  record 
of  any  individual  soldiers,  can  follow  up  the  case  after 
return  to  employment,  and  help  in  many  ways  to  make 
«  the  re-education  permanently  effective. 

The  actual  work  of  putting  the  disabled  American 
soldier  back  on  his  feet  is  still  in  its  infancy,  and  many 
details  still  remain  to  be  worked  out  in  experience.  But 
in  principle,  the  United  States  has  followed  the  best 
example  of  her  Allies — in  accepting  provision  for  the 
disabled  soldiers  as  a  national  responsibility  to  be  met 
at  public  expense.    It  is  clear  that  no  American  soldier 


232  THE      DISABLED      SOLDIER 

need  be  dependent  upon  the  alms  of  charity  for  his  re- 
habilitation. 

But  the  complete  success  of  the  work  rests  with  the 
people  of  the  United  States — upon  whether  we  sympa- 
thetically grasp  and  effectively  express  in  our  relations 
with  the  graduates  of  re-education  the  new  spirit  of 
dealing  with  the  disabled — upon  whether  we  sense  the 
glory  of  restoring  the  ex-soldier's  ability  to  earn  his  own 
living,  or  whether  we  continue  the  old  temporary  hero- 
worship  and  permanent  pauperization.  The  self-respect 
of  self-support  or  the  ignominy  of  dependence — which 
shall  the  future  hold  for  our  disabled  soldiers?  The 
credit  or  the  blame  for  the  decision  will  largely  rest 
with  the  American  public. 

The  open  road  is  before  us. 


Printed  in  the  United  States  of  America. 


npHE  following  pages  contain  advertisements  of  a  few 
of  the  Macmillan  books  on  kindred  subjects. 


Reclaiming  the  Maimed 

A  Handbook  of  Physical  Therapy 


By 
R.  TAIT  McKENZIE,  M.D. 

Major,  Royal  Army  Medical  Corps, 

Professor  of  Physical  Therapy, 

University  of  Pennsylvania. 

Pocket  Handbook  Size;  Waterproof  Covers;  profusely  Illustrated 
with  Photographs  and  Diagrams.  Price,  $2.00. 

The  remarkable  work  accomplished  by  Major  McKenzie  and  as- 
sociates, by  special  authorization  of  the  Surgeon  General  of  the 
British  Armies,  in  rehabilitating  and  returning  to  the  battle  front  many 
thousands  of  men  who  were  previously  considered  as  permanently  dis- 
abled, as  well  as  his  success  in  restoring  and  returning  to  civil  pursuits 
thousands  of  others,  is  fully  described  in  this  important  book.  Not 
only  does  Major  McKenzie  explain  what  has  been  done,  but  he  offers 
many  new  methods,  together  with  brand  new  apparatus,  while  the  text 
is  supplemented  by  an  unusual  collection  of  photographs  and  drawings 
which  make  his  material  instantly  applicable  for  use  by  the  jnedical 
man,  the  masseur  or  nurse. 

Major  McKenzie's  methods  of  treatment  are  now  actually  being 
taught  and  practically  applied  in  the  hospitals  of  the  Military  Hospitals 
Commission  of  Canada  along  the  lines  described,  while  the  Surgeon 
General's  office  of  the  United  States  Army  has  approved  of  and  urged 
the  immediate  publication  of  the  book.  It  is,  therefore,  particularly 
timely  not  only  for  practical  use  in  war  work,  but  in  the  rehabilitation 
of  those  crippled  by  accidents  in  industrial  plants. 


THE  MACMILLAN  COMPANY 

Publishers        64-66  Fifth  Avenue        Ifew  York 


325  Group  Contests  for  the  Army, 
Navy  and  School 

By  W.  J.  CROMIE 

Author  of  "Keeping  Physically  Fit,"  etc. 
With  many  illustrations. 

Cloth,  i2tno. 

Here  is  a  book  which  the  leaders  of  boys'  clubs,  gymnasium 
instructors,  Y.  M.  C.  A.  workers,  as  well  as  physical  directors 
in  army  and  navy  camps,  will  find  distinctly  valuable.  Its 
purpose  is  to  build  up  strong  bodies  and  it  has  been  written 
by  one  who  has  had  long  experience  in  work  with  young  men 
in  this  direction.  In  addition,  there  is  the  appeal  of  the  con- 
test. Dr.  Cromie  has  so  arranged  his  text,  that  the  desire  to 
excel  is  implanted  in  his  students.  The  book  splendidly  an- 
swers the  requirements  of  those  who  have  longed  for  some- 
thing which  shall  give  the  class  or  group  in  physical  training 
something  to  do,  which  shall  keep  their  interests  keen  and 
active  and  shall  develop  them  physically,  at  the  same  time. 
The  many  illustrations  make  beautifully  clear  the  author's 
instructions. 


THE   MACMILLAN   COMPANY 

Publishers        64-66  Fifth  Avenue        New  York 


The  New  Public  Health 

Bv  Dr.  fflBBERT  WINSLOW  HILL 

Director,  Institute  of  Public  Health,  and  Medical  Officer  of  Health  of  Lon- 
don, Canada;  Professor  of  Public  Health,  Western  University. 

$1.25. 

"Common  sense  distinctly  marks  the  brilliant  exposition 
of  the  methods  employed  in  tracing  the  courses  of  epidemics 
by  medical  officers  with  modern  training  in  progressive  com- 
munities which  Dr.  Hill  calls  'The  New  Public  Health.'  .... 
The  shifting  back  upon  the  individual  his  share  of  the  responsi- 
bility which  has  been  put  upon  the  State  is  essential  to  the  pre- 
vention and  extirpation  of  disease.  The  author's  style  is  vig- 
orous, so  that  it  is  impossible  not  to  understand  the  points  he 
makes;  he  hits  out  from  the  shoulder  and  puts  into  a  few  pages 
more  hard  sense  than  can  be  extracted  from  volumes  of  scien- 
tific report.  It  is  a  book  that  every  citizen  who  has  any  regard 
for  his  duties  should  read." — The  New  York  Sun. 

"In  an  interesting  way  Dr.  Hill  has  analyzed  the  revolu- 
tionary changes  that  have  taken  place  in  the  pubUc  attitude 
toward  the  public  health,  and  studied  the  problem  of  the  pub- 
lic apathy  to  constructive  sanitation.  His  new  book  'The  New 
Public  Health'  is  a  survey  of  the  field,  tracing  first  the  dif- 
ferences between  the  old  attitude  and  the  new;  and  second, 
pointing  out  the  actual  achievements  in  public  and  individual 
defense  against  infection  and  contagion.  .  .  .  The  book  dis- 
cusses in  detail  the  work  of  the  public  health  engineer,  statis- 
tician and  laboratory,  particularly  in  reference  to  the  pubUc 
health  of  the  future.  .  .  .  The  work  is  optimistic,  construc- 
tive, and  gives  a  sound  working  knowledge  of  what  has  been 
done  and  a  practical  program  for  procedure  in  the  future." — 
Philadelphia  Public  Ledger. 


THE   MACMILLAN   COMPANY 

Publishers         64-66  Fifth  Avenue         New  York 


The  Martial  Adventures 
of  Henry  and  Me 

By  WILLIAM  ALLEN  WHITE 

Cloth,  $1.50 

"  A  jolly  book  .  .  .  truly  one  of  the  best  that  has  yet 
come  down  war's  grim  pike." —  New  York  Post. 

"  Honest  from  first  to  last.  .  .  .  Resembles  '  Innocents 
Abroad '  in  scheme  and  laughter  ...  a  vivid  picture  of 
Europe  at  this  hour.  Should  be  thrice  blessed,  for  man 
and  book  light  up  a  world  in  the  gloom  of  war." — New 
York  Sun. 

"A  unique  chronicle,  genuine  and  sincere." — New 
York  Times. 

Here  is  a  book  of  truth  and  humor.  One  of  the  first 
stories  by  an  American  that  tell  what  America  has  done 
and  is  doing  "  over  there."  It  is  a  tale  such  as  Mark 
Twain  would  have  written  had  he  lived  to  do  his  bit  in 
France. 

Two  "  short,  fat,  bald,  middle-aged,  inland  Amer- 
icans "  cross  over  to  France  with  commissions  from  the 
Red  Cross.  Their  experiences  are  told  in  a  bubbling  humor 
that  is  irresistible.  The  sober  common  sense  and  the 
information  about  the  work  going  on  in  France  —  the  way 
our  men  take  hold  and  the  French  respond  —  go  to  make 
this  the  book  all  Americans  have  long  been  waiting  for. 

The  inimitable  sketches  of  Tony  Sarg,  distributed 
throughout,  lend  a  clever,  human  atmosphere  to  the  text. 


THE  MACMILLAN  COMPANY 

Publishers     64-66  Fifth  Ayenue     New  York 


I 


'A 

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405  Hllgard  Avenue,  Los  Angeles,  CA  90024-1388 

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